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Similarities and differences between primary OA and the arthropathy associated with acromegaly

Similarities and differences between primary OA and the arthropathy associated with acromegaly
Similarities
  • Synovial fluid noninflammatory (cell count <2000 WBC)
  • Clinical features of joint stiffness, crepitus, and worsening pain with activity
  • Increasing prevalence with age
Distinguishing features
Primary OA Acromegalic arthropathy
Affects a sizable minority of population (35% of general population with radiographic OA of knee[1]) 70 to 90% of patients with acromegaly have radiographic joint involvement
Radiographic features: Joint space narrowing, osteophyte formation, and subchondral cysts Radiographic features: In initial stages, joint space widening may occur; in later stages, osteophyte formation may predominate over joint space narrowing (only 1/3 of hip disease with cartilage narrowing[2])
Classic sites of involvement in OA: DIP joints, PIP joints, base of thumb, lumbar and cervical spine, hip, knee, 1st MTP joint OA in joints that shouldn't get OA: Involvement of MCP joints, shoulder, elbow, and others can occur due to disruption in normal cartilage growth and metabolism
OA: osteoarthritis; WBC: white blood cells; DIP: distal interphalangeal; PIP: proximal interphalangeal; MTP: metatarsophalangeal; MCP: metacarpophalangeal.
References:
  1. Nguyen USDT, Zhang Y, Zhu Y, et al. Increasing prevalence of knee pain and symptomatic knee OA: survey and cohort data. Ann Intern Med 2011; 155:725.
  2. Claessen KM, Kloppenburg M, Kroon HM, et al. Two phenotypes of arthropathy in long-term controlled acromegaly? A comparison between patients with and without joint space narrowing (JSN). Growth Horm IGF Res 2013; 23:159.
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