RADIOLOGICAL FEATURES OF ACROMEGALY,CUSHING SYNDROME,HYPERTHYROIDISM AND HYPOTHYROIDISM
Q1.Tufting of the terminal
phalanges (arrow head appearance) and
increased heel pad thicknes is seen in
a.alkaptonuria
b.hyperthyroisism
c.acromegaly
d.cushing
syndrome
Q2.Small or absent frontal sinuses
are noted in all except
a.congenital
absence
b.hyperthyroidism
c.Down’s
syndrome
d.kartagener’s
syndrome
ANS---1==c ===acromegaly
2==b===hyperthyroidism
RADIOLOGICAL FEATURES OF ACROMEGALY
| Skull | Vault thickened |
| Paranasal and mastoid air cells enlarged | |
| Pituitary fossa enlarged | |
| Floor of the fossa asymmetrical or ballooned | |
| Mandible | Prognathism with increased angle |
| Spine | Kyphosis |
| Enlarged vertebral bodies | |
| Posterior scalloping of vertebral bodies | |
| Chest | Increased antero-posterior diameter |
| Ribs increased in calibre and length | |
| Hands | General enlargement |
| Enlarged bases of phalanges and terminal tufts, spade-like | |
| Enlarged muscle attachments | |
| Feet | Thickening of ‘heel pad': M > 23 mm, F > 21.5 mm |
| Long bones | Thickened by periosteal new bone formation |
| Joints | Widening of joint spaces due to thickened cartilage |
| Premature degeneration (OA) changes (shoulders, hips, knees) | |
| Chondrocalcinosis | |
| Soft tissues | Enlarged heart, kidneys, liver |
| Calcification of pinna of ears |
| Skull | Pituitary fossa usually normal |
| Skeleton | Osteoporosis |
| Vertebral collapse | |
| Kyphosis | |
| Concave vertebral margins | |
| Wedged vertebral bodies | |
| Rib fractures—multiple, painless with excess callus | |
| Necrosis of femoral heads | |
| Secondary osteoarthritis |
| Skull | Unfused sutures |
| Skeleton | Small but normal proportions (Lorain dwarf) |
| Slender bones | |
| Small pituitary fossa | |
| Unfused epiphyses |
| Skull | Exophthalmos |
| Skeleton | Osteopenia |
| Cortical striation—acropachy | |
| In childhood, early appearance and accelerated growth of ossification centres | |
| Heart | Cardiac enlargement |
| Cardiac failure | |
| Thymus | Enlargement |
| Skull | Delayed closure of fontanelles |
| Relatively large sella | |
| Poorly developed paranasal sinus | |
| Usually brachycephalic | |
| Dentition delayed: dental caries | |
| Wormian bones | |
| Skeleton | Dwarfism |
| Increased density | |
| Ossification centres | Retarded growth |
| Multicentric and irregular | |
| Bilateral and symmetrical | |
| Epiphyses | Delayed fusion and appearance |
| Inhomogeneous epiphyses | |
| Fine or coarse stippling | |
| Fragmentation | |
| Spine | Kyphosis |
| Flattening of bodies | |
| Increase in width of intervertebral space | |
| Bullet-shaped vertebral bodies, usually L1 and L2 | |
| Long bones | Short |
| Dense transverse bands at metaphyseal ends M >23mm, F > 21.5mm | |
| Pelvis | Narrow with coxa vara |
| Heart | Enlargement |
| Pericardial effusion | |
| Heart failure | |
| Body cavities | Pleural effusion |
| Ascites | |
| Gastrointestinal tract | Abnormalities of oesophageal peristalsis |
| Decreased incidence of peristalsis | |
| Constipation | |
| ‘Pseudo-obstruction’ |
REF:
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