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Acromegaly is an insidious disease being present for many years (6-10) before actual diagnosis. Due to its rarity and slow evolution, this condition remains undiagnosed for many years. Interestingly, the signs and symptoms may result in the diagnosis being made by a spectrum of physicians including dentists, ophthalmologists, cardiologists and pulmonologists. Sometimes friends or family members may notice the physical changes through old pictures or at reunions. Patients themselves may notice some of the recognized symptoms and signs such as an increase in shoe, hat or ring size. History A full medical and past surgical history is an integral part of patient evaluation. It will help direct the physician in the assessment of co-morbid complications. An equally important part of the history is the ascertainment of a full psychosocial history in order that patient and family concerns, problems and dynamics may be addressed. Suspicion of Acromegaly is supported by the classical signs and symptoms. Review of old photographs of the patient, as far back as possible, is useful as well.
Examination A full physical examination including vital signs, height and weight is essential in all patients. The examination should aim to elicit as many of the signs (listed above) of Acromegaly as possible.
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