A common factor in hypertrophic osteoarthropathy

Abstract

L. (1974). Thorax, 29,[262][263][264]. A common factor in hypertrophic osteoarthropathy. Two cases of oesophageal disease with hypertrophic osteoarthropathy are presented. The unusual site of the primary lesion has prompted a review of the literature and led to the conclusion that there is a common innervation accounting for a common afferent arc which is an integral and basic part of the mechanism in this disorder.The pathogenesis of hypertrophic osteoarthro-barium swallow showed the presence of a sliding pathy (HO) remains an enigma. It may be hiatus hernia. Oesophagoscopy revealed the presence associated with disease in a variety of organs and of severe confluent, ulcerative oesophagitis from in a wide range of pathological conditions in the cardia to the level of the aortic arch. those organs. We present two unusual and rare Repair of the hiatus hernia was carried out in causes of HO and propose a common factor in all cases of HO. CASE REPORTS PATIENT 3. M. A 78-year-old woman presented in 1959 with a three-month history of increasing dysphagia. For four to five months before admission she had noted swelling and stiffness in both ankles and wrists. Pitting oedema was easily demonstrable on the dorsum of the feet, ankles, and lower part of the legs and on the dorsum of the hands. Radiographs showed well-marked periosteal new bone formation on the tibiae, fibulae (Fig. 1), radii, and ulnae. Chest films and bronchoscopy were normal; in particular there was no evidence of bronchial carcinoma. Oesophagoscopy and biopsy revealed an adenocarcinoma in the middle third of the oesophagus.In view of the patient's age and frailty no operative intervention was undertaken and she died shortly after.PATIENT S. L. A 51-year-old man presented with a 10-year history of heartburn, especially at night; vomiting, occasionally with blood, was noted several times. From 1969 he had had aerophagy and slight dysphagia referred to the lower half of the sternum. From 1968 he had swollen and stiff ankles, stiff knees and wrists, and marked finger and toe clubbing.The chest film appearances were normal, but radiographs of the femora, tibiae, fibulae, and radii (Fig. 2

Hypertrophic osteoarthropathy: two unusual causes

“…It is known to occur in association with a number of other neoplasms and benign conditions arising in the territory of distribution of the vagus nerve. Oesophageal carcinoma is known to cause HOA occasionally (Coury, 1962;Carroll and Doyle, 1974;Maurice-Williams and Wilson, 1969;Peyman, 1959). An association with pulmonary tuberculosis has been described in the Siberian tiger in a single case report (Van de Watering, Zwart and Bakker, 1972), but not in man.…”

“…Unusual causes of hypertrophic osteoarthropathy (HOA) have previously been reported from this centre (Carroll and Doyle, 1974). We wish to record two further cases; one of these, oesophageal carcinoma, although rare, is a well known cause while the other, pulmonary tuberculosis, has not been recognised before.…”

Hypertrophic pulmonary osteoarthropathy and its occurrence with pulmonary metastases from renal carcinoma.

“…Carroll and Doyle (1974) have also suggested a reflex arc and noted the area of the primary disease to be served by the ninth or tenth cranial nerves. Hormonal Theory (Fig.…”

Hypertrophic Osteopathy Associated with Mycotic Pneumonia in Two Juvenile Elk (Cervus Elaphus)

“…?show "fnote_aff1"$^! "content-markup(./author-grp [1]/aff|./author-grp [1]/dept-list)> Two yearling bull elk (Cervus elaphus) were presented to the Purdue University Veterinary Teaching Hospital (West Lafayette, IN) for a primary complaint of decreased appetite, weight loss, and lameness. The elk were born on a commercial farm, with approximately 385 elk raised for meat, velvet, and breeding.…”

“…This may account for a common afferent arc that forms a basic part of the mechanism responsible for osteoarthropathy. 1 Other factors proposed to be involved include hyperestrogenism, deficient oxygenation, and increased blood flow. [4][5][6] The presence of severe pulmonary aspergillosis in these 2 elk most likely contributed to the development of HO.…”