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hypertrophic osteoarthropathy
Etiology:
1) primary hypertrophic osteoarthropathy (idiopathic)
2) hypertrophic pulmonary osteoarthropathy
- cystic fibrosis
3) patent ductus arteriosus
4) Crohn's disease
5) myelofibrosis
6) carcinoma, paraneoplastic syndrome [2]
Pathology:
1) neoangiogenesis & edema & osteoblast proliferation in distal tubular bones leading to subperiosteal new-bone formation
2) excessive proliferation of skin & bone at distal parts of the extremities
Clinical manifestations:
1) oligo or polyarthritis
a) symmetrical arthralgias
b) large joint involvement (knees, elbows, ankles, wrists)
c) synovial effusions, pitting edema
2) digital clubbing
3) painful periostosis of the long bones
4) alleviation of pain by elevating affected extremities
Radiology:
- chest X-ray for hypertrophic pulmonary osteoarthropathy
- chest CT for lung carcinoma
Specific
hypertrophic pulmonary osteoarthropathy (Bamberger-Marie syndrome)
primary hypertrophic osteoarthropathy (pachydermoperiostosis)
General
osteoarthropathy
References
- eMedicine: Hypertrophic Osteoarthropathy
http://emedicine.medscape.com/article/333735-overview
- Medical Knowledge Self Assessment Program (MKSAP) 14, 17.
American College of Physicians, Philadelphia 2006, 2015