Spade phalanx sign (acromegaly)

Spade phalanx sign refers to a characteristic distal phalangeal shape in acromegaly.

Radiographic features

Plain radiographs

The terminal phalangeal tufts become hypertrophied and have a "spade appearance".

Other findings on hand radiography of acromegaly include

• joint spaces may be minimally enlarged
• premature osteoarthritis may occur

Differential diagnosis

• acromegaly
• macrodactyly
• normal variant: consider if other hand findings of acromegaly are not present