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Comparison of hand x-rays from acromegalic (left) and a normal "large male" (right)

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On the left is the hand x-ray of a 38-year-old acromegalic man. "[W]hile the bones of the fingers are apparently of normal length, the fingers, because of the outlines of the soft tissue, appear to be short in proportion to the enormously large palm. The osteophytic overgrowth of the ungual phalanges is very marked...; the distal margin is most affected, although the circumference of the articulating surfaces also shows considerable exostosis. ... [A]ll the seats of muscular or fascial attachment on the phalanges and metacarpal bones are exaggerated. This is also try, though in less degree, of the bones of the carpus. The sesamoid bone of the thumb is apparently slightly enlarged." (Source: Brooks H. Acromegalia. Arch Neurol Psychopathol 1898;1[3]:485-678. Plate II, figures 1 and 2. The montage was created by Dr. Douglas J Lanska, and a portion of figure 2 was cropped out so that a comparable portion of the hand and wrist was shown from both individuals.)