To evaluate whether or not the radiographic changes in the hands alone can help assess or establish the diagnosis of acromegaly, the authors performed a number of measurements, i.e., soft tissue width of fingers, width of phalanx, width of the M-P joint, sesamoid index, interstyloid distance, and soft tissue index. Each of the measurements showed significant differences between the acromegalic and control groups. Except for the width of the M-P joint, each of the measurements also showed significant variations between the sexes. The soft-tissue thickness of fingers was found to be not as sensitive as the heel-pad thickness. This was also true of other measurements in the hands. No single measurement was specific for acromegaly. However, the concomitant findings of increased soft-tissue thickness of fingers, widening of M-P joint, with exostosis and marginal spurs were sufficient to establish the diagnosis of acromegaly. Increased width of phalanges, large sesamoid index, and increased interstyloid distances were helpful signs, especially in borderline cases.
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