Hypertrophic osteoarthropathy

Changed by Matt Skalski, 6 Jun 2014

Updates to Article Attributes

Body was changed:

Show markup changes

Hypertrophic osteoarthropathy is characterised by a proliferative periostisis involving the long bones seen most commonly in patients with lung, liver, an GI disorders. When associated with a lung condition it is also termed hypertrophic pulmonary osteoarthropaty (HPOA). It is usually painful and associated with clubbing of the fingers or toes. The causes of hypertrophic osteoarthropathy include :

lung
- bronchogenic carcinoma : non small cell lung cancer is the strongest malignant association
- pulmonary lymphoma
- lung abscess
- bronchiectasis
- pulmonary metastases (esp. from osteosarcoma)
- pleural fibroma
- mesothelioma
- cyanotic congenital heart disease
gastrointestinal tract and liver
familial
idiopathic

Radiographic features

Plain film

Typically seen as a long metaphyseal and diaphyseal smooth periosteal reaction involving the long bones.

With disease progression, periostitis becomes more prominent or multilayered, and extends to the epiphyses¹.

Differential diagnosis

Consider the differential for a smooth periosteal reaction.

~~-<a href="/articles/bronchogenic-carcinoma">bronchogenic carcinoma </a>: <a href="/articles/non-small-cell-lung-cancer">non small cell lung cancer</a> is the strongest malignant association</li>~~
+<a href="/articles/lung-cancer-3">bronchogenic carcinoma </a>: <a href="/articles/non-small-cell-lung-cancer">non small cell lung cancer</a> is the strongest malignant association</li>
~~-<li><a title="chronic venous insufficiency" href="/articles/chronic-venous-insufficiency">chronic venous insufficiency </a></li>~~
+<li><a href="/articles/chronic-venous-insufficiency">chronic venous insufficiency </a></li>
~~-<li><a title="Hypervitaminosis A" href="/articles/vitamin-a-related-abnormalities">hypervitaminosis A</a></li>~~
+<li><a href="/articles/vitamin-a-related-abnormalities">hypervitaminosis A</a></li>

Images Changes:

Image 5 X-ray (AP) ( create )

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":571134,"studyId":11877,"caseSlug":"hypertrophic-osteoarthropathy","caption":"Case 1","thumbnail":"https://prod-images-static.radiopaedia.org/images/571134/21cd54ef06b3315af9d2e803f62921_big_gallery.jpg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":1989227,"studyId":17753,"caseSlug":"hypertrophic-osteoarthropathy-1","caption":"Case 2","thumbnail":"https://prod-images-static.radiopaedia.org/images/1989227/b6cf4916942e03ac35053fc6116567_big_gallery.JPG","isStack":true,"diagnosticCertainty":"probable"},{"imageId":4715625,"studyId":25186,"caseSlug":"hypertrophic-osteoarthropathy-2","caption":"Case 3","thumbnail":"https://prod-images-static.radiopaedia.org/images/4715625/6bde24a5addd9e791e44a824e76f327b26dd12759db2781863fb305d5170d789_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":7336123,"studyId":30095,"caseSlug":"hypertrophic-osteoarthropathy-3","caption":"Case 4","thumbnail":"https://prod-images-static.radiopaedia.org/images/7336123/88e27d6cac72f4357f9e797902cad7_big_gallery.jpg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":18921123,"studyId":45478,"caseSlug":"hypertrophic-pulmonary-osteoarthopathy","caption":"Case 5 ","thumbnail":"https://prod-images-static.radiopaedia.org/images/18921123/0981bd7907113551bc15ffbc79ef3e_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":22460889,"studyId":49243,"caseSlug":"hypertrophic-pulmonary-osteoarthropathy-3","caption":"Case 6","thumbnail":"https://prod-images-static.radiopaedia.org/images/22460889/c038f4e8a91cbc885a432c5269c6af_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":5735334,"studyId":44725,"caseSlug":"hypertrophic-pulmonary-osteoarthropathy","caption":"Case 7","thumbnail":"https://prod-images-static.radiopaedia.org/images/5735334/dd0c4f0d0d48b79f8c95ab179859fe_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":40611785,"studyId":69553,"caseSlug":"hypertrophic-osteoarthropathy-5","caption":"Case 8","thumbnail":"https://prod-images-static.radiopaedia.org/images/40611785/4a66102e6f49f0042dac621ffeef32_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":54228076,"studyId":101780,"caseSlug":"solid-periosteal-reaction-hypertrophic-osteoarthopathy-1","caption":"Case 9: secondary to lung adenocarcinoma","thumbnail":"https://prod-images-static.radiopaedia.org/images/54228076/Frontal_-_zoomed_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":55847668,"studyId":110884,"caseSlug":"adenocarcinoma-lung-hypertrophic-osteoarthropathy","caption":"Case 10: secondary to lung adenocarcinoma","thumbnail":"https://prod-images-static.radiopaedia.org/images/55847668/0._big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":60942959,"studyId":130797,"caseSlug":"hypertrophic-osteoarthropathy-9","caption":"Case 11","thumbnail":"https://prod-images-static.radiopaedia.org/images/60942959/7b509826efc77349d25e03ce770b888577f338c935b5d6f662e17d95689f0ba4_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"}],"ddx_inclusions":[{"imageId":567027,"studyId":11679,"caseSlug":"chronic-venous-stasis","caption":"Chronic venous stasis","thumbnail":"https://prod-images-static.radiopaedia.org/images/567027/2a3d3a44871a4689a3f23693183251_big_gallery.jpg","isStack":false,"diagnosticCertainty":"probable"}],"lang":"us"}