title: Acromegalic arthropathy in various stages of the disease: an MRI study.
abstract: BACKGROUND
  Arthropathy is a prevalent and invalidating complication of acromegaly with a characteristic radiographic phenotype. We aimed to further characterize cartilage and bone abnormalities associated with acromegalic arthropathy using magnetic resonance imaging (MRI).
  
  
  METHODS
  Twenty-six patients (23% women, mean age 56.8 ± 13.4 years), with active (n= 10) and controlled acromegaly (n= 16) underwent a 3.0 T MRI of the right knee. Osteophytes, cartilage defects, bone marrow lesions and subchondral cysts were assessed by the Knee Osteoarthritis Scoring System (KOSS) method. Cartilage thickness and cartilage T2 relaxation times, in which higher values reflect increased water content and/or structural changes, were measured. Twenty-five controls (52% women, mean age: 59.6 ± 8.0 years) with primary knee OA were included for comparison.
  
  
  RESULTS
  Both in active and controlled acromegaly, structural OA defects were highly prevalent, with thickest cartilage and highest cartilage T2 relaxation times in the active patients. When compared to primary OA subjects, patients with acromegaly seem to have less cysts (12% vs 48%,P= 0.001) and bone marrow lesions (15% vs 80%,P= 0.006), but comparable prevalence of osteophytosis and cartilage defects. Patients with acromegaly had 31% thicker total joint cartilage (P< 0.001) with higher cartilage T2 relaxation times at all measured sites than primary OA subjects (P< 0.01).
  
  
  CONCLUSIONS
  Patients with active acromegaly have a high prevalence of structural OA abnormalities in combination with thick joint cartilage. In addition, T2 relaxation times of cartilage are high in active patients, indicating unhealthy cartilage with increased water content, which is (partially) reversible by adequate treatment. Patients with acromegaly have a different distribution of structural OA abnormalities visualized by MRI than primary OA subjects, especially of cartilage defects.
authors.affiliation: Departments of Endocrinology & Metabolic Diseases and Center for Endocrine Tumors Leiden.
authors.forename: K M J A
authors.initials: KMJA
authors.lastname: Claessen
authors.affiliation: Departments of Radiology.
authors.forename: A Navas
authors.initials: AN
authors.lastname: Canete
authors.affiliation: Departments of Radiology.
authors.forename: P W
authors.initials: PW
authors.lastname: de Bruin
authors.affiliation: Departments of Endocrinology & Metabolic Diseases and Center for Endocrine Tumors Leiden.
authors.forename: A M
authors.initials: AM
authors.lastname: Pereira
authors.affiliation: Departments of RheumatologyLeiden University Medical CenterLeiden The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Kloppenburg
authors.affiliation: Departments of Radiology.
authors.forename: H M
authors.initials: HM
authors.lastname: Kroon
authors.affiliation: Departments of Endocrinology & Metabolic Diseases and Center for Endocrine Tumors Leiden.
authors.forename: N R
authors.initials: NR
authors.lastname: Biermasz
mesh_terms: D000172:Acromegaly / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D001845:Bone Cysts / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002356:Cartilage / Q000000981:diagnostic imaging / Q000473:pathology; D002357:Cartilage Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000473:pathology; D010865:Pilot Projects; D015995:Prevalence; D012074:Remission Induction; D012720:Severity of Illness Index