Acromegalic arthropathy of the hip

The changes in gross morphology of the femoral head, specimen radiograms, cut sections of the femoral heads, and histopathology of the synovium were examined in 11 surgical specimens from six acromegalic patients who were treated by total hip arthroplasty. The pathologic changes in six age- and sex-matched patients also undergoing 11 total hip arthroplasties for idiopathic degenerative joint disease were examined for comparison. The hip joint changes in acromegaly represent a peculiar arthropathy, which is characterized by prominent, proboscis-like medial osteophytes, moderate chronic lymphoplasmacytic synovitis, an irregular pitting of the subchondral bone observed roentgenographically, and osteopenia. When compared with idiopathic degenerative joint disease, these changes are distinctive in extent, if not in quality. The pathophysiologic relationship between these entities remains obscure.