Bones affected:
(1) distal phalanges of fingers or toes (acro-osteolysis), typically at the terminal digital tuft
(2) middle and proximal phalanges
(3) distal radius and/or ulna
(4) distal clavicle
(5) ribs
(6) mandible
(7) cervical vertebral bodies
(8) any tubular bone
Findings in the fingers may include:
(1) pseudoclubbing
(2) finger tapering
(3) pencil-in-cup deformity on X-ray
(4) shortening of involved digit
Manifestations at all sites:
(1) pain
(2) deformity (change in facial appearance, etc)
(3) disability from loss or change of function (difficulty chewing, etc)
Associations - a patient with osteolysis is more likely to have:
(1) digital ulcers
(2) extra-articular calcifications
(3) pulmonary arterial hypertension
Exclusions:
(1) fracture
(2) avascular necrosis
(3) osteomyelitis
