A Case of Acroosteolysis in Primary Hypertrophic Osteoarthropathy

Hyun Jeong Lee; Hong Jae Kim; Chul Gu Hwang; Jae Hoon Choi; Eun Jin Kang

doi:10.4078/jrd.2013.20.4.247

Journal List > J Rheum Dis > v.20(4) > 1064054

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Lee, Kim, Hwang, Choi, and Kang: A Case of Acroosteolysis in Primary Hypertrophic Osteoarthropathy

Case Report

J Rheum Dis 2013;20(4):247-250.

Published online: 31 August 2013

DOI: https://doi.org/10.4078/jrd.2013.20.4.247

A Case of Acroosteolysis in Primary Hypertrophic Osteoarthropathy

Hyun Jeong Lee, Hong Jae Kim, Chul Gu Hwang, Jae Hoon Choi, Eun Jin Kang

Department of Internal Medicine, Busan Medical Center, Busan, Korea

Corresponding to : Eun Jin Kang, Department of Internal Medicine, Busan Medical Center, 359, Worldcup-dearo, Yonhe-gu, Busan 611-706, Korea. E-mail : jiny0122a@hanamil.net

Received 2 August 201212 August 2012 Accepted 14 August 2012

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Primary hypertrophic osteoarthropathy, Acroosteolysis

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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.

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