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Hyperostosis frontalis interna and association of disease control with frontal bone thickness in acromegaly
Ihsan Ayhan1, Ömercan Topaloğlu2, Taner Bayraktaroğlu2
1Internal Medicine Clinics, Zonguldak Atatürk State Hospital, Zonguldak, Türkiye, Turkey. ihsanayhan@hotmail.com.
Insights
Hyperostosis frontalis interna (HFI) is common in acromegaly and associated with increased frontal bone thickness (FBT). HFI and bone thickness changes appear independent of disease activity, suggesting baseline imaging evaluation.
Area of Science:
- Endocrinology
- Radiology
- Neurosurgery
Background:
- Hyperostosis frontalis interna (HFI) is a condition characterized by thickening of the inner table of the frontal bone.
- Limited studies have investigated HFI in patients with acromegaly.
- Acromegaly, a disorder caused by excess growth hormone, can lead to various skeletal changes.
Purpose of the Study:
- To investigate the prevalence of HFI in acromegaly patients.
- To assess the association between HFI and frontal bone thickness (FBT).
- To explore the relationship between disease control and bone thickness in acromegaly.
Main Methods:
- Adult acromegaly patients were divided into two groups based on the presence (Group 2) or absence (Group 1) of HFI on baseline MRI.
- Frontal, parietal, and occipital bone thickness (FBT, PBT, OBT) were measured.
- Changes in bone thickness over time and associations with disease control status were analyzed.
Main Results:
- HFI was present in 29 out of 52 acromegaly patients.
- Patients with HFI (Group 2) showed significantly higher FBT, PBT, and OBT compared to those without (Group 1).
- Bone thickness showed a continuous increase in HFI patients and was independent of acromegaly disease activity.
Conclusions:
- HFI is a common finding in acromegaly patients.
- HFI is associated with increased and continuously growing bone thickness in the skull.
- Bone thickness and its progression in acromegaly appear unrelated to disease activity, highlighting the importance of baseline imaging for evaluation.
Purpose:
Studies investigating hyperostosis frontalis interna (HFI) in acromegaly are limited. We aimed to investigate HFI and the association of disease control with frontal bone thickness (FBT) in acromegaly.
Methods:
Adult patients with acromegaly were grouped according to the presence of HFI on the baseline MRI: Group 1 absent, Group 2 present. We measured FBT, parietal bone thickness (PBT) and occipital bone thickness (OBT) in the mid-sagittal plane on MRI. The changes between first and last measurements were analyzed. We grouped the patients as controlled vs. uncontrolled acromegaly, and as established disease control for at least 5-year vs. 1-5-years.
Results:
Group 1/Group 2 comprised of 23/29 patients, female/male ratio was 34/18, and mean age 55.41(± 14.21) years. Median follow-up duration was 108 months (6-408). FBTfirst (p = 0.001), FBTlast (p < 0.001), PBTlast (p = 0.025), and OBTlast (p = 0.028) were higher in Group 2 than in Group 1. FBTchange, PBTchange, and OBTchange were positive in Group 2 (p < 0.001, p = 0.008, and p = 0.008; respectively). The ratio of patients with FBT(increased) was higher in Group 2 than in Group 1 (p = 0.001). FBTfirst, FBTlast, PBTfirst, PBTlast, OBTfirst, OBTlast, FBTchange, PBTchange and OBTchange were similar in controlled or uncontrolled acromegaly groups. FBTchange and OBTchange were positive in patients with disease control established for at least 5 years (n = 30) (p = 0.027 and p = 0.002, respectively).
Conclusion:
HFI was common in patients with acromegaly. HFI is associated with a continuous increase in FBT, PBT and OBT. HFI, bone thickness, or increase in bone thickness seems independent of disease activity. Since headaches can be related to an increase in bone thickness, patients should be evaluated and graded during baseline imaging.
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