Osteoarthropathy with acromegaly: symptoms and treatment

Acromegaly || Signs And Symptoms Of Acromegaly || Acromegaly Clinical Features (Health And Medical Video July 2018).

What are the causes of acromegalia and acromegalic osteoarthropathy and the main clinical manifestations of the disease.

Acromegaly is a relatively rare and severe endocrine disorder caused by excessive pituitary growth hormone (somatotropic hormone) and/or its high activity.

The incidence in Ukraine is on average 5-7 cases per 100 thousand. The life expectancy of patients in half of the cases of acromegaly does not exceed 50 years.

Causes of arthropathy in acromegaly

The basis of the development of acromegalia in 95% of cases lies hyperproduction of the somatotropic hormone (STH) adenoma of the pituitary gland.

This causes an increased production of a number of growth factors leading to excessive collagen formation, increased growth of cartilage tissue, increased soft tissue and bone growth (if it occurs at younger ages).

At the same time there is an accelerated growth of the peripheral parts of the limbs, to a lesser extent - the bones of the skeleton, the lower jaw. Acromegalic osteoarthropathy is a leading syndrome in the clinic of this endocrine disorder.

Features of the manifestation of acromegalic osteoarthropathy

Arthropathies are observed in more than 75% of acromegalia cases. In this case, the major joints are most severely affected: the knee, hip, shoulder, as well as the cervical and lumbar sacral parts of the spine, lesser in the process of the small joints of the extremities.

Patients begin to develop degenerative-dystrophic changes in joints early in the form of deforming osteoarthritis, but without the phenomena of ankylosis, and movement in the joints is accompanied by crisp (crepitation).

In addition, enhanced collagen production in para-articular tissues leads to hypermobility in the joints and even thickening of intraarticular cartilage (this is manifested in X-rays as enlargement of the articular cracks). In addition, half of patients have carpal tunnel syndrome, and one third of patients develop Raynaud's syndrome.

An increase in articular bags and compartmentalization of the periarticular tissue leads to an increase in the volume of the joints, and can also provoke chondrocalcinosis (deposits of calcium pyrophosphate salts in cartilage tissue).

Forecast acromegalic osteoarthropathy

The earlier the diagnosis of the disease and the timely start of treatment, the more likely the reverse development of bone changes.

Diagnosis of osteoarthropathy with acromegaly

Diagnosis of arthropathy is based on a set of clinical and laboratory-instrumental studies, including the most important X-ray examination of joints, spine and skull (or MRI).

Treatment of acromegalic osteoarthropathy

The basis of therapy is the treatment of the underlying disease, which led to the occurrence of acromegaly.

For this purpose microsurgical methods of treatment of pituitary adenomas, radiation and drug therapy, but more often combined methods of treatment are used most often.

In addition, symptomatic therapy is being performed, including aimed at reducing the manifestations of osteoarthropathy.

Osteoarthropathy with acromegaly: symptoms and treatment

Category Of Medical Issues: Diseases

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