Acromegaly physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Patients with acromegaly usually appear tired. Physical examination of patients with acromegaly is usually remarkable for skin tags, acanthosis nigricans, and hyperhidrosis. Common findings in physical examination include frontal bossing, headache, macroglossia, and prognathism. Cardiovascular findings include ventricular hypertrophy, heart failure, and arrhythmias. Skeletal findings include joint effusion, osteopenia, kyphoscoliosis, muscle weakness, paraesthesia, and malocclusion of the mouth leading temporomandibular joint tenderness.

• Patients with acromegaly usually appear tired
• Patient is usually oriented to persons, place, and time

• Hypertension

• Thickening of the skin
• Skin tags
• Acne
• Acanthosis nigricans
• Hyperhidrosis

• 
  Description Template:Acanthosis nigricans in the axilla

• Abnormalities of the head include frontal bossing
• Acral enlargement
• Visual deficits
• Hearing acuity may be reduced
• Facial tenderness
• Headache
• Macroglossia
• Prognathism

• Obstruction of the upper airways
• Obstructive sleep apnea

Cardiac manifestations in acromegaly patients include the following:^[1][2]

• Ventricular hypertrophy
• Diastolic heart failure (the most common cause of death)
• Diastolic and systolic dysfunction
• Arrhythmias
• Cardiomyopathy

• Colon diverticula

• Vertebral fractures

• Osteopenia
• Osteoarthritis
• Joints effusion, swelling, and crepitus
• Acromegaly rosary: hypertrophy of the ribs and costochondral junction enlargement in the chest wall.^[3]
• Muscle weakness
• Joint stiffness in late cases
• Malocclusion of patient jaw associated with temporomandibular joint tenderness
• Kyphoscoliosis^[4]
• Paraesthesia
• Cranial nerves palsy
• Carpal tunnel syndrome

• In females:^[5]
  • Amenorrhea
  • Galactorrhea
• In males:^[5]
  • Sexual dysfunction
  • Loss of libido
  • Gynecomastia

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