Difficult venepuncture – it was all in the head!

Abstract

Seemingly trivial abnormalities may prove clinically important. One presentation of acromegaly is hard-to-puncture skin.

Difficult access in the anaesthetic room leads to a difficult diagnosis:

“…About 70% of patients have joint symptoms at diagnosis; 70% of patients have large joint arthropathy. 17 If the disorder arises in young adults before the epiphyseal plates fuse this results in accelerated growth and gigantism, and fusion of the epiphyseal plates is also delayed because of associated secondary hypogonadism. 18 Hypertension and carpal tunnel syndrome are also common and are seen in most patients.…”