Acromegaly and Osteoarthritis: a retrospective study of joint involvement in the spine, thorax, and shoulder complex

BACKGROUND: Acromegaly is a severe neuroendocrine disorder caused by growth hormone hypersecretion, leading to various organ-system complications. In acromegaly, radiographic signs of osteoarthritis (OA) involving multiple joints develop even before the diagnosis of acromegaly is established and continue to progress over time, despite biochemical remission.

AIM: To identify the features of spinal, thoracic cage, and shoulder girdle joint involvement in patients with acromegaly.

MATERIALS AND METHODS: A single-center, observational, cross-sectional, retrospective comparative study. The study included patients with acromegaly; the sample was formed using a consecutive sampling method. Recruitment period: October 2022 — November 2024. A comparison of the features of the spinal, thoracic cage, and shoulder girdle joints was conducted between patients with acromegaly and a control group.

RESULTS: The study included 98 patients with acromegaly, including 55 women (56.1%) and 43 men (43.9%). The mean age at diagnosis was 36 [31; 45] years, and at the time of examination, 39.5 [32; 46] years. The control group included 12 men (48%) and 13 women (52%). The median age was 45 [39; 54] years.

In patients with acromegaly, radiographic signs of costovertebral OA were associated with older age and were more frequent in 35 patients with a median age of 44 [39; 54] years (p=0.001), with a cutoff point of ≥39 years. OA of the acromioclavicular joints was more frequent in males (p=0.006). When comparing the two groups, costovertebral OA was more frequent in patients with acromegaly (p=0.001).

CONCLUSION: Costovertebral OA can be considered a specific musculoskeletal disorder in patients with acromegaly, while spondyloarthrosis, OA of the sternocostal, shoulder, and acromioclavicular joints are not. The results of our study demonstrate the need for a comprehensive assessment of MSK pathology in patients with acromegaly. The obtained data can serve as a basis for improving rehabilitation algorithms and differential diagnosis of comorbidities in this cohort of patients.

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