Fig. 23.1 
Acromegaly: lateral skull film showing vault changes and a 'ballooned' pituitary fossa.
 The main role of radiology in the assessment of acromegaly is to confirm the presence of a pituitary tumour and to provide information necessary for treatment and follow-up. Certain characteristic systemic changes do, however, occur in acromegaly and this lateral skull film demonstrates typical diffuse hyperostosis of the calvanum and abnormally large frontal sinuses. A double floor to the pituitary fossa can be seen. One side is of normal calibre and the other is grossly expanded i.e. ‘ballooned’.