Joint Involvement in Patients with Acromegaly and the Association Between Arthropathy and Disease Remission

Abstract

Abstract

Aim: To evaluate joint complaints, physical examinations and X-rays of acromegalic patients and investigate association between arthropathy and disease remission and effects of arthropathy on quality of life.

Method: Acromegalic patients followed at Endocrinology clinic of Cerrahpasa Medical Faculty between 2015-2017 were screened. Demographic and disease status, physical examinations and quality of life scales (Acro-QoL) were recorded. The symptoms and examination findings of patients consulted with Rheumatology or Physical Therapy-Rehabilitation departments and X-rays were evaluated, retrospectively.

Results: Ninety-seven patients were assessed, 38 patients (F/M:31/7; p=0.006) had joint complaints and 59 (60.8%; F/M: 40/19; p>0.05) had pathological joint findings. Pathological joint signs were found in 30 patients with no symptoms, whereas 9 out of 38 patients who declared joint symptoms had no signs at rheumatological examination. Patients with symptoms and signs were older (47.6±11.5 vs 53.3±11.9; p=0.02 and 44.3±9.1 vs 53.4±12.3; p<0.001, respectively). When patients were evaluated according to remission status as remission with medical treatment (n=43), remission after surgery(n=27) and active disease (n=18); duration of disease in active disease group was shorter (p=0.01). Other parameters were similar between groups. There was a significant correlation between AcroQoL and shoulder and AcroQoL and small hand joints involvements (p=0.007, r=-0.2 vs p=0.004, r=-0.3), whereas no correlation was found between AcroQoL and knee or elbow involvements. No association found between disease duration and symptoms, examination findings, radiological findings or AcroQoL.

Conclusion: Joint degenerative changes detected in 60% of acromegalic patients, and affect quality of life, Regular evaluation of joint symptoms is recommended in the management of acromegalic patients.