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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
| Spectrum of Voriconazole-Induced Periostitis With Review of the Differential Diagnosis., Tan I,Lomasney L,Stacy GS,Lazarus M,Mar WA,, AJR. American journal of roentgenology, 2018 Nov 7 [PubMed PMID: 30403528] | |
| A male Korean who was diagnosed with chronic enteropathy associated with {i}SLCO2A1{/i} (CEAS): case report with literature review., Sun X,Hosoe N,Miyanaga R,Kimura K,Mizuno S,Takabayashi K,Naganuma M,Niizeki H,Seki A,Ogata H,Kanai T,, BMJ open gastroenterology, 2018 [PubMed PMID: 30397504] | |
| Novel SLCO2A1 mutations cause gender differentiated pachydermoperiostosis., Yuan L,Chen X,Liu Z,Wu D,Lu J,Bao G,Zhang S,Wang L,Wu Y,, Endocrine connections, 2018 Aug 1 [PubMed PMID: 30352415] | |
| Co-morbidity with hypertrophic osteoarthropathy: A possible Iron Age Sarmatian case from the Volga steppe of Russia., Loyer J,Murphy E,Ruppe M,Moiseyev V,Khartanovich V,Zammit J,Rottier S,Potrakhov N,Bessonov V,Obodovskiy A,, International journal of paleopathology, 2018 Oct 5 [PubMed PMID: 30296644] | |
| Targeted exome sequencing identified a novel mutation hotspot and a deletion in Chinese primary hypertrophic osteoarthropathy patients., Chen Y,Li G,Xu Y,Yu T,Zhang Y,Li N,Yao RE,Zhou Y,Wang X,Shen Y,Yin L,Wang J,, Clinica chimica acta; international journal of clinical chemistry, 2018 Oct 4 [PubMed PMID: 30292630] |
