J Rheum Dis.  2013 Aug;20(4):247-250. 10.4078/jrd.2013.20.4.247.

A Case of Acroosteolysis in Primary Hypertrophic Osteoarthropathy

Affiliations
  • 1Department of Internal Medicine, Busan Medical Center, Busan, Korea. jiny0122a@hanamil.net

Abstract

Primary hypertrophic osteoarthropathy or pachydermoperiostosis is a rare hereditary disorder characterized by digital clubbing, pachydermia and periostosis. Its precise incidence and prevalence is still unknown due to the lack of controlled data. It occurs without any underlying causes and usually has a chronic course. Life expectancy may be of normal standards, but many patients develop multiple functional and cosmetic complications. So, it is important to diagnose this disease at an early stage and to treat the symptomat for the quality of life. We report a case of primary hypertrophic osteoarthropathy in a 68-year-old male with clinical features such as digital clubbing and pachydermia, radiographic findings of acroosteolysis and periosteal new bone formation.

Keyword

Primary hypertrophic osteoarthropathy; Acroosteolysis

MeSH Terms

Acro-Osteolysis
Aged
Humans
Incidence
Life Expectancy
Male
Osteoarthropathy, Primary Hypertrophic
Quality of Life

Figure

  • Figure 1. Digital clubbing on both hands and the amputated 5 th mid phalanx of left hand are seen.

  • Figure 2. (A) Plain radiograph of both hands demonstrate acroosteolysis. Extensive bone lysis of distal phalanges with bases for the preservation are seen. (B) Plain radiograph of lower extremities shows irregular linear cortical thickening of both proximal tibia (white arrows) and periosteal new bone formation.

  • Figure 3. Tc-99m HDP scan finding shows diffuse and symmetrical increased uptakes of radionuclide in a linear pattern along the periosteal surfaces of both proximal tibia.


Reference

References

1. Friedreich N. Hyprstose es gesmmten skelettes. Arh Pathol Ant. 1868; 43:83–7.
2. Castori M, Sinibaldi L, Mingarelli R, Lachman RS, Rimoin DL, Dallapiccola B. Pachydermoperiostosis: an update. Clin Genet. 2005; 68:477–86.
Article
3. Martí nez-Lavín M, Vargas AS, Cabré J, Nava A, Silveira LH, Amigo MC, et al. Features of hypertrophic osteoarthropathy in patients with POEMS syndrome: a metaanalysis. J Rheumatol. 1997; 24:2267–8.
4. Jajic Z, Jajic I, Nemcic T. Primary hypertrophic osteoarthropathy: clinical, radiologic, and scintigraphic characteristics. Arch Med Res. 2001; 32:136–42.
5. Touraine A, Solente G, Golé L. Un syndrome osteo-dermopathique: la pachydermie plicaturee avec pachyper-ostose des extremites. Presse Med. 1935; 43:1820–4.
6. Silveira LH, Martí nez-Lavín M, Pineda C, Fonseca MC, Navarro C, Nava A. Vascular endothelial growth factor and hypertrophic osteoarthropathy. Clin Exp Rheumatol. 2000; 18:57–62.
7. Poormoghim H, Hosseynian A, Javadi A. Primary hypertrophic osteoarthropathy. Rheumatol Int. 2012; 32:607–10.
Article
8. Paik MH, Lee BY, Lee KH, Song KS, Kim JW, Min KO. Pachydermoperiostosis (primary hypertrophic osteoarthropathy): case report. J Korean Radiol Soc. 2002; 47:533–8.
Article
9. Pineda CJ, Guerra J Jr, Weisman MH, Resnick D, Martinez-Lavin M. The skeletal manifestations of clubbing: a study in patients with cyanotic congenital heart disease and hypertrophic osteoarthropathy. Semin Arthritis Rheum. 1985; 14:263–73.
Article
10. Hedayati H, Barmada R, Skosey JL. Acrolysis in pachydermoperiostosis. Primary or idiopathic hypertrophic osteoarthropathy. Arch Intern Med. 1980; 140:1087–8.
Article
11. Joseph B, Chacko V. Acroosteolysis associated with hypertrophic pulmonary osteoarthropathy and pachydermoperiostosis. Radiology. 1985; 154:343–4.
Article
12. Lee J, Kim H, Hwang JW, Noh JW, Ahn JK, Koh EM, et al. Arthroscopic synovectomy in a patient with primary hypertrophic osteoarthropathy. J Korean Rheum Assoc. 2008; 15:261–7.
Article
13. Cooper RG, Freemont AJ, Riley M, Holt PJ, Anderson DC, Jayson MI. Bone abnormalities and severe arthritis in pachydermoperiostosis. Ann Rheum Dis. 1992; 51:416–9.
Article
14. Kwon MH, Joung CI. Pachydermoperiostosis mimicking ac-romegaly: A case report. Turk J Rheumatol. 2012; 27:132–5.
Article
15. Hong YS, Yang HI, Park SH, Lee SH, Cho CS, Kim HY. A case of Sjogren syndrome associated with acroosteolysis. J Korean Rheum Assoc. 1996; 3:92–6.
Full Text Links
  • JRD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr