Week 4, Hypertrophic Osteoarthropathy

Question 1

Briefly define the term hypertrophic osteoarthropathy

Answer 1

Clubbing, arthralgia of neighbouring joints, periosteal bone growth

Question 2

List the triad of pathological changes that are seen in hypertrophic osteoarthropathy

Answer 2

• Periosteal new bone formation (long bones, metacarpals, metatarsals, proximal phalanges)
• Clubbing (due to oedematous, fibrovascular overgrowth in the tips of the digits. Becomes dusky and cyanotic in colour)
• Arthralgia/arthritis in adjacent joints

Question 3

In which conditions is hypertophic osteoarthropathy commonly seen?

Answer 3

• Lung cancer (usually adenocarcinoma)
• Other tumours (eg nasopharyngeal cancer)
• Nonmalignant pulmonary disorders
• Right-to-left cardiac shunts
• Chronic lung infection
• Chronic liver disease

Question 4

9. In which conditions is isolated clubbing commonly seen?

Answer 4

• Lung cancer (usually adenocarcinoma)
• Other tumours (eg nasopharyngeal cancer)
• Nonmalignant pulmonary disorders
• Right-to-left cardiac shunts
• Chronic lung infection
• Chronic liver disease
• Cyanotic heart disease
• Infective endocarditis/aortitis
• Crohn’s disease
• Ulcerative colitis
• Cancer of the oesophagus/colon