Osteoarthropathy in acromegaly : Symptoms and Treatment

What causes acromegaly and akromegalicheskoy osteoarthropathy and the main clinical manifestations of the disease.

Acromegaly - a relatively rare and difficult flowing endocrine disorder caused by excess production of pituitary growth hormone (growth hormone) and / or increased activity.

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

Causes of arthropathy in acromegaly

At the heart of acromegaly in 95% of cases is overproduction of growth hormone (GH) pituitary adenoma.

This causes increased production of a number of growth factors, leading to excessive formation of collagen, the strong growth of cartilage, increase the volume of soft tissue and bone growth (if it occurs at a young age).

Thus there is preferential growth of the peripheral extremities, to a lesser extent - the bones of the skeleton, mandible.Akromegalicheskaya osteoarthropathy is a leading syndrome in the clini

c of the endocrine diseases.

Peculiarities of akromegalicheskih osteoartropathy

Arthropathy observed in more than 75% of cases of acromegaly.The most severely affected large joints: the knee, hip, shoulder and cervical and lumbosacral spine, at least in the process involves smaller joints of the extremities.

Patients begin to appear early degenerative-dystrophic changes in joints by type deforming osteoarthritis, but without signs of ankylosis, and the movements are accompanied by the crunch (crepitus) in the joints.

In addition, enhanced production of collagen in the para-articular tissues leads to hypermobility of the joints and even intra-articular cartilage thickening (on the X-ray is shown in the form of expansion joint gaps).In addition, half of the patients is observed carpal tunnel syndrome, and a third of patients develop Raynaud's syndrome.

Increase periarticular bags and seal periarticular tissues leads to an increase in the volume of the joints and can cause chondrocalcinosis (calcium pyrophosphate deposition of salts in the cartilage).

forecast akromegalicheskoy osteoarthropathy

The earlier the diagnosis of the disease and timely treatment is started, the more likely regression of bone changes.

Diagnostic osteoarthropathy in acromegaly

arthropathy diagnosis is put on the basis of complex clinical, laboratory and instrumental studies, of which the most important is the X-ray examination of joints, the spine and the skull (or MRI).

Treatment akromegalicheskoy osteoarthropathy

The basis of treatment is treatment of the underlying disease that led to the emergence of acromegaly.

To do this most often used Microsurgical treatment of pituitary adenoma, radiation and drug therapy, but more often - combined treatments.

In addition, symptomatic therapy, including those aimed at reducing the manifestations osteoartropathy.

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