Acromegaly X-ray & Imaging Studies

This is a lateral view of a pituitary adenoma. Please note the expanded sella turcica (between the orbit on the left and the radio-dense mastoid on the right).


Radiographic features of abnormalities of the hand and wrist in a female patient aged 48 yr with an estimated disease duration of 8–10 yr. At the hand, note at terminal phalanges the enlargement of tuft and bases. At metacarpophalangeal joints, it is worth noting the widening of some articular spaces, whereas at the proximal interphalangeal joints there is narrowing of others. Note the width of some proximal phalanges resembling the presence of "beak-like" osteophytes at the level of distal interphalangeal joints and at proximal interphalangeal joints. Periarticular calcific deposits are also present. At the wrist, note the enlargement of distal radius and ulna as well as at ulnar styloid. Lateral to the radius, some "beak-like" osteophytes can be appreciated.

Radiographic features of bone proliferation at sites of tendon and ligament attachment to bone (enthesopathy) in a female patient aged 48 yr with an estimated disease duration of 8–10 yr. Note the proliferation along the posterior margin of the calcaneus. This is a proliferative enthesopathy different from the common enthesopathy occurring in other rheumatic diseases. This latter spondyloarthopathy is characterized by a primary erosive, due to local release of cytokines, and a secondary proliferative process.

Sagittal spin-echo T1-weighted MR image (420/15, 90° flip angle) of a sparsely granulated GH-producing adenoma in a 61-year-old woman. The height of the adenoma is 23 mm. The adenoma has grown in an infrasellar direction (arrows). No suprasellar component is noted.

Coronal fast spin-echo T2-weighted MR image (3,710/108, 90° flip angle) of a sparsely granulated GH-producing adenoma (large solid arrows) in a 45-year-old woman. This massive adenoma is hyperintense. Invasion of the right side of the cavernous sinus is seen with the displaced right internal carotid artery (open arrow) and the lateral wall of right side of the cavernous sinus (small solid arrows).