Hypertrophic pulmonary osteoarthropathy is a rare condition associated with a number of pulmonary, cardiac and gastrointestinal conditions. A patient with idiopathic hypertrophic pulmonary osteoarthropathy should be carefully screened for an occult intra-thoracic neoplasm.


Clinical features:

(1) painful, symmetrical arthropathy usually affecting the wrists, ankles and knees

(2) painful proliferative periostitis that affects the distal long bones and that can be seen on X-rays. Erythema and edema may be present over the affected bones. Involvement of the lower legs can make walking difficult.

(3) variable neurovascular changes of the hands and feet

(4) may co-exist with digital clubbing


The condition tends to improve on treatment of the underlying cause and recurs on relapse.


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