Hypertrophic Osteoarthropathy

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Hypertrophic Osteoarthropathy is a disease of the joints and bones. It is characterized by clubbing of the digits of the hands and feet, enlargement of the extremities as a consequence of periarticular and osseous proliferation, and painful and swollen joints. Two categories are recognized, primary and secondary.

More often than not, this disease is asymptomatic, meaning it does not show any symptoms at all. But other patients may feel deep pains in their bones, usually in the area near the legs. There are also thickening in the wrists and the ankles. The patient’s fists can also be swollen and digital clubbing is apparent. Digital clubbing is a type of a fingernail deformity. Aside from all these, several other dermatological symptoms may develop.


  • Fewer than a third of patients have a relative who is affected, with a male-to-female ratio of 9:1. Disease onset has a bimodal peak, with one in the first year of life and one at puberty. The activity of the illness is limited to the growth period, with adults becoming asymptomatic. Long-standing clubbing and a positive family history suggest primary HOA, but excluding any associated illness is still of utmost importance.
  • With congenital and familial clubbing, most often patients are asymptomatic and have relatives with the same disorder.
  • Goldbloom syndrome is a rare, painful, hypertrophic periostosis occurring primarily in children. Clubbing and skin involvement are usually absent. The clinical picture consists of a high fever with weight loss and severe bone pain in the mandibles and long bones. It is accompanied by a major acute phase reaction and polyclonal hypergammaglobulinemia. The syndrome spontaneously resolves in 4-8 weeks, and radiographic and bone scan abnormalities return to normal within the next few years. Long-term follow-up shows normal growth thereafter, without permanent sequelae.

  • Treatment:
    In terms of medication therapy, non-steroidal anti-inflammatory drugs or NSAIDS are given to reduce the discomforts arising from hyperthropic osteoarthropathy. The most common example of this drug is the aspirin. Along with it, calcium channel blockers and analgesics are also given. Some drugs referred to as steroid derivaties prove to be useful as well.

    It is always a given that if a disease is associated with any type of symptom, the said symptoms have to be addressed first. This is especially required if hypertrophic osteoarthropathy is caused or is complicated by cardiac anomalies or even cancer. For these cases, special antibiotics should be prescribed.

    The more severe cases of this disease may require several radiotherapy sessions to correct the tumors that develop. Chemotherapy is also performed so to address the disease and everything else associated with it. There are also cases wherein a liver transplant does a patient good for lung abscess, pneumonia, bronchiectasis, and bacterial endocarditis that are brought about by the disease.


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