Context

Acromegalic arthropathy is a well-known phenomenon, occurring in the majority of patients regardless of disease status. To date, solely hips, knees, hands, and spinal joints have been radiographically assessed.

Objective

To assess the prevalence of joint symptoms and radiographic osteoarthritis (OA) of new, and established peripheral joint sites in well-controlled acromegaly.

Design and setting

Cross-sectional study in tertial referral center.

Patients

Fifty-one acromegaly patients (56% female, mean age 64±12years) in long-term remission for 18.3 years (median, IQR 7.2 – 25.4) were included. Nineteen patients received current pharmacological treatment.

Main outcome measures

Self-reported joint complaints were assessed using a standardized interview. Self-reported disability of the upper and lower limbs, and health-related quality of life (HR-QoL), were evaluated using validated questionnaires. Radiographic OA was scored using (modified) Kellgren&Lawrence (KL) methods, and was defined as KL≥2.

Results

Radiographic signs of OA were present in 46 patients (90.2%), which occurred in a generalized manner in virtually all patients (N=44; 95.7%). Radiographic MTP1 OA was as prevalent as radiographic knee OA (N=26, 51.0%), and radiographic glenohumeral OA was similarly prevalent as hip OA (N=21 (41.2%) vs N=24 (47.1%)). Risk factors for radiographic glenohumeral OA were higher pre-treatment IGF-1 levels (OR 1.06 (1.01 – 1.12), P=0.021), and current pharmacological treatment (OR 5.01 (1.03 – 24.54), P=0.047), whereas no risk factors for MTP1 joint OA could be identified.

Conclusions

Similar to previously assessed peripheral joints, clinical and radiographic arthropathy of the shoulder and feet were prevalent in controlled acromegaly. Further studies on adequate management strategies of acromegalic arthropathy are needed.