Acromegaly¶
Overview¶
Excess growth hormone causes characteristic spinal changes including increased vertebral body height and AP diameter, posterior vertebral body scalloping from dural ectasia, widened disc spaces, and premature degenerative changes. The vertebral bodies appear enlarged on radiography.
Imaging Findings¶
- Increased vertebral body size (height and AP diameter)
- Posterior vertebral body scalloping (from dural ectasia)
- Widened disc spaces (increased cartilage growth)
- Premature disc degeneration and osteophyte formation
- Spinal stenosis from bony overgrowth
Clinical Pearl
Posterior vertebral body scalloping has a differential: acromegaly, dural ectasia (Marfan syndrome, NF1), intraspinal tumors (chronic pressure), and increased intrathecal pressure (communicating hydrocephalus). Acromegaly also enlarges the vertebral bodies, which helps distinguish it from other causes of scalloping.
Key Points¶
- Enlarged vertebral bodies with posterior scalloping are characteristic
- Premature degenerative changes and spinal stenosis develop
- Posterior scalloping differential includes Marfan, NF1, and intraspinal tumors
References¶
- Adigun OO, Nguyen M, Fox TJ, Anastasopoulou C. Acromegaly. In: StatPearls. Treasure Island (FL): StatPearls Publishing; updated 2023 Feb 2. https://www.ncbi.nlm.nih.gov/books/NBK431086/
- Baptista LC, Martins MM, Marcos VN. Radiographic findings in acromegaly: pictorial essay. Radiol Bras. 2023;56(2):110-115. https://pmc.ncbi.nlm.nih.gov/articles/PMC10165974/
- de Azevedo Oliveira B, Araujo B, Dos Santos TM, et al. The acromegalic spine: fractures, deformities and spinopelvic balance. Pituitary. 2019;22(6):601-606. https://pubmed.ncbi.nlm.nih.gov/31556014/
- Sorohan MC, Poiana C. Vertebral Fractures in Acromegaly: A Systematic Review. J Clin Med. 2022;12(1):164. https://pmc.ncbi.nlm.nih.gov/articles/PMC9821150/
- Wydra A, Stelmachowska-Banas M, Czajka-Oraniec I. Skeletal complications in acromegaly. Reumatologia. 2023;61(4):248-255. https://pmc.ncbi.nlm.nih.gov/articles/PMC10515128/
- Jones J, Knipe H, Sattar A, et al. Acromegaly. Radiopaedia.org. https://radiopaedia.org/articles/acromegaly
- Gaillard F, Knipe H, Murphy A, et al. Vertebral scalloping. Radiopaedia.org. https://radiopaedia.org/articles/vertebral-scalloping