defeat of the joints occurs in 75% of patients with acromegaly and has its own characteristics.
Acromegaly - a rare pathological condition caused by excessive production of pituitary growth hormone (usually associated with pituitary adenoma), which manifests itself in the form of proliferation of bone and cartilage, as well as the development of fibrosis in the periarticular tissues.
main manifestations of arthropathy in acromegaly
- changes are observed in almost all the joints of limbs, as well as in the cervical and lumbosacral spine.One of the most typical signs of acromegaly is pronounced deforming osteoarthritis, accompanied by the crunch in joints, sealing periarticular tissues, increase in periarticular bags.
- increase in the fingers, often with the deformation in the form of "drumsticks", increase incremental, sesamoid bones and peripheral bone sections (lower jaw, heel bones, nail phalanges), and an increased tendency to formation of marginal osteophytes in the field of fixing themtend
ons and ligaments.
- spine in patients with acromegaly deformed mainly due to the strengthening of the thoracic kyphosis and lumbar lordosis, scoliosis, which is associated with impaired bone structure and increase in volume of the vertebral bodies.At the same time there comes a limit mobility ribs when breathing and the formation of barrel-shaped chest
- often occurs in patients with carpal tunnel syndrome associated with non-uniform increase in para-articular tissues and bones in the wrist.
- Very often, patients concerned about pain in the muscles, combined with an increase in their size and increasing weakness, 1/3 of all patients is determined by Raynaud's syndrome (intermittent spasms of peripheral arterial vessels, accompanied by painful manifestations in the field of circulatory disorders).
Diagnostics arthropathy in acromegaly.
Often a preliminary diagnosis the doctor has already put on the basis of the appearance of the patient, but in cases where acromegaly is just beginning to develop, for example, at the beginning of growth of pituitary adenoma, diagnosis can be difficult.
a role in proper diagnosis plays X-ray examination in which the identified characteristic changes in the structure of bones and joints:
- «diversity» bone structure due to the presence of multiple foci of osteosclerosis and osteoporosis,
- proliferation of cartilage, which is shown increasing altitudeX-articular slits, that is, increases joint gaps,
- bulavopodobnoe thickening of nail phalanges and periosteal layers on tubular bones,
- occasionally there are manifestations of chondrocalcinosis (deposition of calcium salts in the cartilage and connective tissue).
- Magnetic resonance tomography of the brain revealed the restructuring of the Turkish saddle, increasing its size and change the structure of the pituitary -availability tumor or vascular changes and other diseases)
treatment of arthropathy in acromegaly
Arthropathy in acromegaly usually can not be cured,it runs its own or stops the progress, if the cause of its development (pituitary tumor) was eliminated at an early stage of its formation, in other cases only stops the progression of arthropathy.When complaints of pain in the joints, extremities, spine, etc.symptomatic therapy