Hypertrophic osteoarthropathy

Types:

1. Primary: AKA pachydermoperiostosis, an autosomal dominant disorder
2. Secondary: malignancy (HPOA)

Features: 

• clubbing
• painful swelling of the limbs, 
• periosteal new bone formation and 
• arthralgia/arthritis. 

most common causes:

• Bronchial carcinoma and 
• Mesothelioma. 

Investigation: 

• X-ray: periosteal new bone formation
• Bone scan: increased periosteal uptake 

Treatment:

• Treatment of the underlying disorder: malignancy 

• NSAIDs
• Pamidronate (IV infusion)

Prognosis:

• The course follows that of the underlying malignancy 
• HPOA resolves if this is cured.