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The acromegalic arthropathy.

A Colao1, R Pivonello, R Scarpa

  • 1Section of Endocrinology, Department of Molecular and Clinical Endocrinology, Federico II, University of Naples, Naples, Italy. colao@unina.it

Journal of Endocrinological Investigation
|December 6, 2005
PubMed
Summary
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Acromegaly causes progressive joint damage, primarily affecting bones and leading to osteoarthritis. Early treatment normalizing growth hormone (GH) and IGF-I levels can reverse arthropathy, but long-term damage is irreversible.

Area of Science:

  • Endocrinology
  • Rheumatology
  • Orthopedics

Background:

  • Acromegaly, a disorder caused by excess growth hormone (GH), has been known for over a century.
  • Disease control criteria for acromegaly are continuously evolving.
  • Arthropathy is a major source of morbidity and disability in acromegaly patients.

Purpose of the Study:

  • To review the evolving understanding of acromegaly.
  • To highlight the characteristic bone and joint alterations in acromegaly.
  • To emphasize the importance of early diagnosis and treatment for arthropathy.

Main Methods:

  • Review of historical and current literature on acromegaly.
  • Analysis of radiographic and clinical features of acromegalic arthropathy.

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  • Discussion of the progression and reversibility of joint damage.
  • Main Results:

    • Bone and joint alterations are characteristic of acromegaly, affecting the axial and appendicular skeleton.
    • Radiographic changes in joints are more prevalent than symptomatic involvement.
    • Acromegalic arthropathy progresses from cartilage hypertrophy to degenerative changes and osteoarthritis.

    Conclusions:

    • Early normalization of GH and IGF-I levels is crucial for reversing acromegalic arthropathy.
    • Untreated acromegaly can lead to irreversible osteo-articular sequelae.
    • Modern criteria necessitate a re-evaluation of disease control in acromegaly.