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Although an uncommon occurrence in childhood, hypertrophic osteoarthropathy secondary to tumors- most commonly to osteogenic sarcoma with pulmonary metastasis-may cause severe join pain and swelling. The syndrome should be considered in the differential diagnosis of acute arthritis in childhood
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We treated twenty-three patients with secondary hypertrophic osteoarthropathy (SHO). Lung cancer was associated with SHO in 21 cases. The underlying conditions for the rest of the patients were pulmonary fibrosis, bronchiastasic, pneumonia and mediastinal cancer. The history, physical examination, radiography and bone-scan were performed. For bone-scan it was used intravenously instilled disfonate compound marked with 99 mTc-HMDP-"Osteocis" in the dosage of 740 MBq. Mild periostosis on the shaft bones was found in 5 patients with positive radio-labelling. In other patients bone-scan showed polytopic radiolabelling whilst radiography didn't show and periostosis. In conclusion we can say that the bone-scan is very sensitive method for the detection of the increase bone-tissue function.
Localized hypertrophic osteoarthropathy is a reported manifestation of--and an important diagnostic clue to--infection of an aortic graft and aortoenteric fistula, two complications of vascular bypass surgery that carry a significant risk of mortality. This clue may lead to the early diagnosis essential to a successful outcome. The authors describe a patient with localized unilateral hypertrophic osteoarthropathy secondary to infection of an aortobifemoral graft and aortoenteric fistula.
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We report the case of a patient suffering from ulcerative colitis with secondary hypertrophic osteoarthropathy. We describe the pathological findings and present a model of the pathogenesis in the Strümpell-Pierre-Marie-Bamberger syndrome.
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BACKGROUND: Hypertrophic osteoarthropathy (HOA) is a syndrome that manifests itself by clubbing of fingers, periosteal and osteal neoformation in acral bones and oligo- or polysynovitis. It may occur as primary form (mostly hereditary) or secondary form, associated with various diseases, especially neoplastic or infectious diseases. PURPOSE: The purpose of the study was to point out that when the symptoms of HOA occur, it is necessary to search for the primary disease, which is usually represented by tumor. METHODS: The study reports a case of a patient with symptoms of HOA, pulmonary adenocarcinoma confirmed by histological examination, and with metastases spread into peripheral lymph nodes. The examination of symptomatology of HOA indicated that to pulmonary carcinoma. RESULTS: The medical history of the patient shows that if there is, at an early stage, little attention paid to the fact that HOA represents a paraneoplastic syndrome, cancer is then confirmed later at a more advanced stage. Neglection of this fact delays the primary diagnosis, deteriorates the prognosis and limits the treatment by the extent of the cancerous process. CONCLUSION: In practice, manifestations of HOA may point to the primary cancerous disease. When the symptomatology of HOA appears, radiograms usually pick up tumours at their early stages, which is important for the prognosis and the strategy of their treatment. The situation was different with the case reported in the study, because the disease was diagnosed at a more advanced stage, which unfavourably affected the prognosis and the treatment of the disease. (Tab. 1, Fig. 4, Ref. 15.)
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