title: Three-dimensional soft tissue analysis of the hand: a novel method to investigate effects of acromegaly.
abstract: BACKGROUND
  Acral overgrowth is a highly common clinical sign in patients with active acromegaly. To what extent this overgrowth persists after long-term remission of acromegaly is largely unknown. Using the new imaging technique of three-dimensional (3D) stereophotogrammetry, it is possible to accurately investigate soft tissue changes of the hand. The aim of the recent study was to compare the 3D soft tissue characteristics of the hands of patients in long-term remission of acromegaly to those of a healthy pair matched control group.
  
  
  METHODS
  A case-control study was performed at a tertiary referral center. Twelve patients in remission of acromegaly (58 % male, mean age 58.3 years, mean BMI 29.6 kg/m2) were compared to twelve age-, gender-, ethnicity-, and BMI-matched control subjects. Of each individual, 3D photographs of both hands were acquired and analyzed using a 3D computer software program.
  
  
  RESULTS
  The patients in long-term remission of acromegaly have overgrowth of soft tissue of the hand compared to matched control subjects, with a larger length and width of the hand (p= 0.0025,p= 0.0017, respectively). Furthermore, the diameters measured at the proximal interphalangeal (PIP) joints of the individual fingers are larger in the acromegaly patients.
  
  
  CONCLUSIONS
  Significant soft tissue overgrowth of the hand persists in former acromegaly patients, even after long-term remission. Analysis of 3D hand photographs is an accurate and easy tool to evaluate the acral soft tissue patterns in acromegaly. Level of Evidence: Level III, diagnostic study.
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Radboud University Nijmegen Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: Inge A
authors.initials: IA
authors.lastname: Hoevenaren
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: M A E M
authors.initials: MA
authors.lastname: Wagenmakers
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: S H P P
authors.initials: SH
authors.lastname: Roerink
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: R T
authors.initials: RT
authors.lastname: Netea-Maier
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Radboud University Nijmegen Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: D J O
authors.initials: DJ
authors.lastname: Ulrich
authors.affiliation: 3D Lab of the Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Thomas J J
authors.initials: TJ
authors.lastname: Maal
keywords: 3D stereophotogrammetry; Acromegaly; Hand analysis; Hand surgery; Three-dimensional imaging