23rd May 2025

A 50-year-old man presents to an endocrinology clinic after suffering from arthritic pain in his knees, coarsened facial features, large spade-like hands, and noticing his wedding ring no longer fits him.

A 50-year-old man presents to an endocrinology clinic after suffering from arthritic pain in his knees, coarsened facial features, large spade-like hands, and noticing his wedding ring no longer fits him. He has a history of hypertension. Initial bloods showed raised IGF-1. A pituitary MRI was done but it showed no abnormality. 

What investigation should be done next to diagnose the cause of this patient’s symptoms?

Select the SINGLE most appropriate option from the list below. Select ONE option only.