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Hypertrophic pulmonary osteoarthropathy

Case contributed by Eric F Greif
Diagnosis almost certain

Presentation

Known history of non-small cell carcinoma, evaluate for metastasis.

Patient Data

Age: 50 years
Gender: Female

A large right lung mass with multiple smaller left lung metastases.

Laminated periostitis of the bilateral femora.

Skeletal survey demonstrates laminated periostitis of the long bones of the appendicular skeleton bilaterally. There is a large right lung opacity on the frontal chest radiograph, consistent with the patient's known non-small cell lung carcinoma. 

Nuclear medicine

Whole body bone scan demonstrates symmetric increase uptake in the diaphyses and metaphyses of the tubular bones of the appendicular skeleton along the cortical margin, matching the findings on X-ray and CT.

Case Discussion

Patient with known non-small cell lung cancer with complaints of joint pain.  Skeletal survey and whole body bone scan were performed for evaluation for metastatic disease.

Laminated periostitis of the diaphyses and metaphyses of the tubular bones of the appendicular skeleton was demonstrated.

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