Authors: K M J A Claessen S R Ramautar A M Pereira J A Romijn H M Kroon M Kloppenburg N R Biermasz
Publish Date: 2013/01/24
Volume: 17, Issue: 1, Pages: 44-52
Abstract
Arthropathy is an invalidating complication of acromegaly This arthropathy deteriorates radiographically despite longterm disease control However the clinical course and its relationship to the radiographic course are currently unknown We aimed to investigate the clinical course of arthropathy during followup and its relationship to radiographic progression in longterm controlled acromegaly patients Prospective followup study We studied 58 patients mean age 62 years women 41 with controlled acromegaly for a mean of 176 years Clinical progression of joint disease was defined at baseline and after 26 years by the Western Ontario McMaster Universities Osteoarthritis Index WOMAC and Australian/Canadian Osteoarthritis Index AUSCAN questionnaires for lower limb and hand OA respectively and performance tests Potential risk factors for progression were assessed The clinical course of arthropathy was related to the radiographic course On average hand and lower limb function deteriorated during followup despite large interindividual variations Joint pain was stable over time High levels of pain and functional impairment at baseline were related to clinical progression of hand pain and functional limitations High baseline BMI was a risk factor for functional deterioration in the lower limb The changes in symptoms and radiographic progression during followup were not related In treated acromegaly patients joint function deteriorates during prolonged followup despite biochemical disease control although there was interindividual variation Clinical and radiographic course of arthropathy were not related Therefore in clinical practice a combination of clinical and radiographic assessment is necessary to evaluate the course of acromegalic arthropathy
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