Pre PACES Podcast #19 Acromegaly
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Oct 10, 2021 Dr Alison Evans, consultant endocrinologist who runs a pituitary clinic, explains acromegaly basics and why it’s a tricky exam topic. Short segments cover typical presentations, focused hand and visual exams, key bloods and imaging, and treatment choices from surgery to medical options. The chat also touches on complications, follow‑up and real‑world clinical scenarios.
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Dentists And Photos Often Reveal Undiagnosed Cases
- Dentists and family photos often trigger diagnosis: Alison Evans recalls a dentist who suspected acromegaly and a sister comparison that made features obvious.
- She emphasises masks can hide features and photos from years earlier help clinch the change.
Check Facial Features And Visual Fields
- Do assess the face for prognathism, prominent brow ridges, macroglossia, interdental spacing and perform visual fields and fundoscopy.
- Alison Evans highlights bitemporal hemianopia risk and the need to check for goitre and cardiac signs.
Use IGF-1 Not Random GH For Screening
- IGF-1 is the screening test because GH is pulsatile and can be normal intermittently.
- Alison Evans states a normal IGF-1 effectively rules out acromegaly and GPs should include a pituitary profile when testing.