Question
X-ray changes in acromegaly are all except:
| A. |
Lengthened terminal phalanx |
| B. |
Widened joint spaces |
| C. |
Obtuse angle of mandible and lengthening of mandible |
| D. |
Premature osteoarthritis |
|
Correct Answer » A Explanation |
 |
Explanation:
– Acromegaly is caused by excess growth hormone (GH) after epiphyseal plate closure.
– GH causes bony & soft tissue changes visible on X-rays.
– Terminal phalanges mainly cortical bone; they do not lengthen in adults.
– Acromegaly causes thickening/widening of bones but no elongation of terminal phalanges.
– Middle phalanges may lengthen, but terminal phalanx lengthening is uncommon.
– Option A (lengthened terminal phalanx) is incorrect because these bones don’t elongate post-growth plate closure.
– Acromegaly broadens distal phalanges rather than lengthening them.
– Option B (widened joint spaces):
– Joint spaces widen early due to cartilage hypertrophy from GH.
– This is a classic X-ray feature of acromegaly.
– Option C (obtuse angle and mandibular lengthening):
– Mandibular enlargement with obtuse angle is typical.
– This produces characteristic facial changes.
– Option D (premature osteoarthritis):
– GH excess causes cartilage overgrowth and joint degeneration.
– Premature osteoarthritis signs appear on imaging and are typical.
High-Yield:
– Acromegaly causes appositional bone growth, not lengthening of terminal phalanges.
– X-ray findings: widened joint spaces, thickened phalanges/metacarpals, mandibular enlargement, & early osteoarthritis.
– Treatment: surgery, somatostatin analogs, radiotherapy to reduce GH.
– Early diagnosis prevents permanent deformities and joint damage.
