Hypertrophic osteoarthropathy

Abstract

Hypertrophic osteoarthropathy (HOA) is characterized by the presence of digital clubbing and periosteal proliferation of the tubular bones. Most HOA cases are secondary to a severe internal illness such as cyanotic heart disease, lung cancer, chronic liver failure, or Graves’ disease, among many others. HOA can also be present as idiopathic or “primary” form that is also known as pachydermoperiostosis. Plan radiographs of the extremities may reveal periosteal apposition preferentially located on tibias and fibulae. Acroosteolysis of the terminal phalanges may also be seen. When confronting a patient with digital clubbing, of outmost importance is to carefully search for an underlying chest or abdominal disease. Differential diagnosis includes acromegaly and inflammatory arthropathies.