整形外科と災害外科
Online ISSN : 1349-4333
Print ISSN : 0037-1033
ISSN-L : 0037-1033
骨関節症状を呈した acromegaly の2例
楢林 葉子岩崎 勝郎伊藤 信之松本 智子山田 健治高橋 克郎手島 鍛本岡 勉平野 徹
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1992 年 41 巻 1 号 p. 44-48

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The purpose of this study was to investigate the cause of acromegalic arthropathy by examining two cases of acromegaly. Case 1 was a 54 year-old male, who complained of shoulder pain. Osteoarthritic change with osteophyte formation on the medial side of the humeral head were shown radiographically. Osteophyte resection and shaving of the articular surface were carried out. Growth hormone level at the time of surgery was 31.5ng/ml. Histological examination of the osteophyte showed thickening of the cartilage on the articular surface and accelerated enchondral ossification. Case 2, a 56 year-old female, presented with right hip pain. On X-ray examination, excessive osteophyte formation was observed on the edge of the acetabulum and femoral head, however, joint space narrowing was not seen. Right total hip replacement was performed. Growth hormone level at the time of THR was normal (2.9ng/ml), as she had had a pituitary adenomectomy 5 years previously. Histological examination of the femoral head, showed cluster formation on the articular cartilage, however, enchondral ossification was not observed in the cartilage of the osteophyte surface.
Acromegalic arthropathy probably occurs by incongruence of articular surfaces due to hypertrophy of the articular cartilage and osteophyte formation.

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