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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
| Primary hypertrophic osteoarthropathy: Report of two novel genetic variants in the <i>SLCO2A1</i> gene in two Mexican patients., Villarreal-Martínez A,Vázquez-Martínez OT,Martínez-de-Villarreal LE,Garay-Mendoza D,Rodríguez-Vivian C,Ocampo-Candiani J,De La Rosa-Marbán E,Ibarra-Ramírez M,, Indian journal of dermatology, venereology and leprology, 2018 May 15 [PubMed] |
| Hypertrophic osteoarthropathy mimicking a reactive arthritis: a case report and review of the literature., Bozzao F,Bernardi S,Dore F,Zandonà L,Fischetti F,, BMC musculoskeletal disorders, 2018 May 14 [PubMed] |
| FGF23 regulates Wnt/β-catenin signaling-mediated osteoarthritis in mice overexpressing high molecular weight FGF2., Meo Burt P,Xiao L,Hurley MM,, Endocrinology, 2018 Apr 26 [PubMed] |
| Hepatobiliary and Pancreatic: Rare hepatic vascular tumor presenting with hypertrophic osteoarthropathy., Caterson H,Liu K,, Journal of gastroenterology and hepatology, 2018 Apr 24 [PubMed] |
| A novel homozygous mutation in the SLCO2A1 gene causing pachydermoperiostosis: Efficacy of hydroxychloroquine treatment., Alessandrella A,Della Casa R,Alessio M,Puente Prieto J,Strisciuglio P,Melis D,, American journal of medical genetics. Part A, 2018 May [PubMed] |
