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A 54-year-old smoker presents with a history of burning, deep-seated pain around his hands, wrists, knees, and ankles. On examination, he is most tender around his wrists and ankles. X-ray of his distal lower extremities reveals hypertrophic osteoarthropathy. What is his most likely diagnosis?
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Teaching Points
- Hypertrophic osteoarthropathy is characterized by excessive proliferation of skin and bone in the distal extremities.
- Exam will show digital clubbing.
- The pathophysiology involves subperiosteal new bone formation at the distal diaphysis.
- Vascular endothelial growth factor (VEGF) is often elevated in patients with lung cancer, inflammatory bowel disease, and Graves disease.
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PubMed References
| Compound Heterozygous Pathogenic Variants of the 15-Hydroxyprostaglandin Dehydrogenase Gene in a Patient With Hypertrophic Osteoarthropathy: First Case in Korea., Ryu MR,Yang JH,Rhee SY,Cho A,Kim SY,Ki CS,, Annals of laboratory medicine, 2019 Jan [PubMed PMID: 30215240] | |
| Hypertrophic osteoarthropathy: Detecting periosteal inflammation using Doppler ultrasound., Abe N,Kasahara H,Koike T,, European journal of rheumatology, 2018 Jul [PubMed PMID: 30185369] | |
| [Two cases of primary hypertrophic osteoarthropathy with SLCO2A1 gene mutations]., Jin P,Zhang Q,He H,Zhu W,Long X,Mo Z,, Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences, 2018 Jan 28 [PubMed PMID: 30154299] | |
| Hypertrophic Osteoarthropathy, Secondary, Chakraborty RK,Sharma S,, , 2018 Jan [PubMed PMID: 30020714] | |
| A Case of Hypertrophic Pulmonary Osteoarthropathy in Both Upper and Lower Extremities: A Rare Involvement., Okudan B,Coşkun N,Arıcan P,Şefizade R,Naldöken S,, Molecular imaging and radionuclide therapy, 2018 Jun 7 [PubMed PMID: 29889032] |
