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Rheumatology
Shoulder osteoarthritis facilitating the diagnosis of acromegaly
  1. Romain Garofoli1,
  2. Domitille Renard1,
  3. Laura Bessiene2 and
  4. Marie-Martine Lefèvre-Colau1,3
  1. 1Paris Cité University, Department of physical medicine and rehabilitation, Hôpital Cochin - Assistance Publique- Hôpitaux de Paris, Paris, Île-de-France, France
  2. 2Department of Endocrinology and National Reference Center for Rare Adrenal Disorders, AP-HP, Hôpital Cochin, F-75014, Paris, Île-de-France, France
  3. 3INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France
  1. Correspondence to Dr Romain Garofoli; romaingarofoli{at}gmail.com

Abstract

A man in his early 50s presented with mechanical chronic pain and limitation of the active range of motion of the right shoulder. Imaging of the shoulder showed osteophytosis without joint space narrowing or cranial migration of the humeral head. He reported no history of trauma, dislocation arthropathy, clinical or standard biological evidence for septic or inflammatory arthritis, metabolic, haemophilic or endocrine-associated arthropathies. The second medical consultation revealed enlargement and infiltration of hands and feet. Consequently, we suspected acromegaly, which was confirmed by endocrinological diagnosis. Further, an MRI of the pituitary gland showed a sellar tumour. The patient’s shoulder pain was related to undiagnosed acromegalic arthropathy leading to osteoarthritis and was treated by trans-sphenoidal exeresis of the somatotroph adenoma and a somatostatin analogue. In conclusion, acromegaly should be considered in patients with centred glenohumeral osteoarthritis, as an early diagnosis is essential to limit complications and preserve the quality of life.

  • Pituitary disorders
  • Metabolic disorders
  • Disability
  • Osteoarthritis
  • Musculoskeletal syndromes

https://doi.org/10.1136/bcr-2023-258545

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: RG, DR, LB, M-ML-C. The following authors gave final approval of the manuscript: RG, DR, LB, M-ML-C. M-ML-C is responsible for the overall content as guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.