Acromegaly and Its Manifestations

Acromegaly is caused by a pituitary adenoma producing excess growth hormone.

Enlarged pituitary fossa is a result of the reduction in the size of the adenoma.

Tufting of the terminal phalanges in acromegaly gives a ‘shield’ appearance.

Cardiac hypertrophy occurs early in the progression of acromegaly.

Acromegaly typically results in decreased joint spaces, particularly in the MCP joints.

Widened bone width in acromegaly occurs with alterations in cortical thickness.

Acromegaly

Caused by a pituitary adenoma, producing excessive growth hormone.
Primarily manifested in the musculoskeletal system.

Skull Manifestations

Thickened skull vault.
Enlarged paranasal sinuses and mastoids.
Enlarged pituitary fossa due to the adenoma.
Prognathism (protruding mandible).

Thorax and Spine Manifestations

Increased sagittal diameter of the chest, with kyphosis.
Increased anterior-posterior (AP) and transverse diameters of vertebral bodies, with posterior scalloping.

Appendicular Skeleton Manifestations

Increased bone width, but unchanged cortical thickness.
Tufting of terminal phalanges, resembling an "arrowhead" shape.
Prominent muscle attachments.
Widened joint spaces (especially metacarpophalangeal (MCP) joints) due to cartilage hypertrophy.
Premature osteoarthritis.
Increased heel-pad thickness (>21.5 mm in women, >23 mm in men).
Generalized osteoporosis.

Extraskeletal Manifestations

Cardiac hypertrophy (early) and dilated cardiomyopathy (late).
Visceromegaly — affecting organs like liver, spleen, kidneys, prostate, thyroid, and salivary glands.
Tracheal cartilage calcification.
Increased risk of diabetes.

This quiz covers the causes and manifestations of acromegaly, particularly focusing on its effects on the skeletal system, including the skull, thorax, spine, and appendicular skeleton. Understand the physiological changes and extraskeletal manifestations associated with this condition.