Article Text

Download PDFPDF
Extended report
Arthropathy in long-term cured acromeagaly is characterised by osteophytes without joint space narrowing: a comparison with generalised osteoarthritis
  1. M J E Wassenaar1,
  2. N R Biermasz1,
  3. J Bijsterbosch2,
  4. A M Pereira1,
  5. I Meulenbelt3,
  6. J W A Smit1,
  7. F Roelfsema1,
  8. H M Kroon4,
  9. J A Romijn1,
  10. M Kloppenburg2,3
  1. 1Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands
  2. 2Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  3. 3Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
  4. 4Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Dr N R Biermasz, Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; n.r.biermasz{at}


Objective To compare the distribution of osteophytes and joint space narrowing (JSN) between patients with acromegaly and primary generalised osteoarthritis to gain insight into the pathophysiological process of growth hormone (GH) and insulin-like growth factor type I (IGF-I)-mediated osteoarthritis.

Methods We utilised radiographs of the knee and hip joints of 84 patients with controlled acromegaly for a mean of 14.0 years with 189 patients with primary generalised osteoarthritis. Hips and knees with with doubtful or definite osteoarthritis (Kellgren–Lawrence score of ≥1) were compared in the current study. For a semiquantitative assessment of radiological osteoarthritis (range 0–3) osteophytes and JSN of the medial and lateral tibiofemoral and hip joints were scored according to the Osteoarthritis Research Society International atlas. Logistic regression analysis was performed with adjustment for age, sex, body mass index and intrapatient effect.

Results Knee and hip osteoarthritis in patients with cured acromegaly was characterised by more osteophytosis (OR 4.1–9.9), but less JSN (OR 0.3–0.5) in comparison with patients with primary osteoarthritis. Patients with acromegaly and osteoarthritis had significantly less self-reported functional disability than patients with primary osteoarthritis (p<0.001). Self reported functional disability was associated with JSN rather than with osteophytosis.

Conclusion Arthropathy caused by GH oversecretion results in osteophytosis and to a lesser extent in JSN. This observation suggests that the GH–IGF-I system is mainly involved in bone formation resulting in osteophytosis, but may possibly protect against cartilage loss.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Medical Ethics Committee of Leiden University Medical Center, Leiden, The Netherlands.

  • Provenance and peer review Not commissioned; externally peer reviewed.