Hyperostosis of lumbar spinous process: a radiological feature in a young acromegalic.

Hyperostosis of the spinous process may be associated with diffuse idiopathic skeletal hyperostosis, Baastrup's disease or acromegaly. Radiological differential diagnosis between them are discussed. No case of hyperostosis of the spinous process has been described clinically or radiologically in young acromegalics. This case represents another manifestation of spinal involvement of acromegaly. Coincidentally, the enthesopathy could also be seen clearly in the middle and proximal phalanges in this young patient. Physicians treating spinal diseases should be aware of chronic backache due to the microtrauma of "kissing" hyperostosis of spinous processes, especially in posterior weight-bearing patients. Hyperostosis of the spinous process, platyspondyly or scalloping of posterior vertebral body, when present alone, is not a diagnostic criteria for acromegaly. But their coexistence in a vertebra is pathognonomic and may serve as an additional diagnostic criteria for acromegaly, especially in young adults.