Endocrine Abstracts

Summary: Objective: To study the clinical manifestations of musculoskeletal complications (MSC) of acromegaly, to improve the early diagnosis of the disease.

Materials and methods: 150 patients with acromegaly were examined who were observed at the RSSPMC of Endocrinology during the period from 2000 to 2020. The age of patients ranged from 19 to 76 years and averaged 43 ± 8.6 years. Of these, 65 (43.3%) were men and 85 (56.7%) women. Moreover, the duration of the disease ranged from 1 year to 23 years.

Results: An analysis of the complaints of our patients showed that the most common complaints of deformation of MSC are an increase in the size of the fingers (96.7%), hands (100%) and feet (98.7%), an increase in the nose, lips (93.3%), changes in facial features (86.7%), swelling of the face and hands (85.3%). More than half of the patients complained of pain (in the spine (73.3%) and in the knees – 56%, in the thigh area – 56.7%). All this led to general weakness and reduced ability to work (88%). As the results of the study showed, in more than half of our patients, different MSCs can be detected by X-ray analysis. So, in 92% of patients, deformation of the phalanges of the hands, feet, thickening of the bones of the skull (92.7%) and signs of osteoporosis of the spine (90%) were detected; 80% have expansion of the periarticular space and deformity of the lower jaw, an increase in sinuses (84%) and signs of osteoporosis of the femurs (80.7%).

Conclusions: 1. Among the clinical manifestations of complications of the musculoskeletal system in our patients were enlarged hands and feet (100%), swelling of the joints (93.3%), expansion of the distal phalanges (92%), swelling of the face (90.6%), prognathism (80%) and diastema (72%), limited mobility of the knee joints (70%) and polyarthralgia (66%). 2. Radiography, being one of the available methods for the diagnosis of MSC of acromegaly, allowed the detection of deformation of the phalanges of the hands in 92% of patients, feet, thickening of the bones of the skull (92.7%) and signs of osteoporosis of the spine (90%); 80% have expansion of the periarticular space and deformity of the lower jaw, an increase in sinuses (84%) and signs of osteoporosis of the femurs (80.7%).

Keywords: acromegaly, musculoskeletal complications, osteoporosis