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Type:
Educational Exhibit
Keywords:
Arthritides, Education, Diagnostic procedure, Nuclear medicine conventional, Digital radiography, CT, Musculoskeletal joint, Musculoskeletal bone, Bones, Inflammation, Metabolic disorders
Authors:
P. Coulson1, J. Rogers2, J. Kao2; 1Knoxville/US, 2Knoxville, TN/US
DOI:
10.1594/ecr2016/C-0695
Background
Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by abnormal proliferation of bone and skin.
While a familial primary form of HOA has been described,
95-97% of cases are a secondary to another disease process.
The etiology of secondary HOA is unclear,
however approximately 90% of cases are associated with pulmonary disease,
especially lung cancer.
Associations with pleural,
cardiac,
and gastrointestinal disease have also been shown [1].
Clinical manifestations of HOA include clubbing and swelling of the digits as well as painful swollen joints.
Diagnostic imaging evaluation of HOA typically reveals diffuse and symmetric periosteal reaction.
This characteristic periosteal reaction classically affects the long bones,
however HOA may also induce radiologic abnormalities in the joints and digits [2].
These findings are readily detectable via multiple imaging modalities,
however other disease processes can produce similar radiologic appearances.
Recognizing the imaging findings specific to HOA is critical to avoid misdiagnosis.