Hypertrophic Osteoarthropathy in Cystic Fibrosis

Pulmonary hypertrophic osteoarthropathy in a child with late-onset agammaglobulinemia

“…Pulmonary HOA without bone pain or other local signs has been reported by Grossman et al in patients with cystic fibrosis [5]. The radiographic picture of HOA is typical and differential diagnosis with idiopathic periosteal hyperostosis [4] was easy because of the presence of clubbing and absence of hypoalbuminemia.…”

“…The pathogenetic mechanism of HOA is still not clear; HOA may represent an advanced manifestation of clubbing resulting from the same pathogenetic mechanism, or the pathogenetic mechanism of the two forms may be different [5,7,8]. Indeed more than one factor probably contributes to the development of HOA.…”

Complications of Cystic Fibrosis Pulmonary Disease

“…In more advanced stages, osteoporosis of cancellous bone and thinning of the cortex may be seen. 70 Although Grossman and associates 66 described radiographic evidence of periostitis in patients without symptoms of osteoarthropathy, it has been more common in our experience to be unable to demonstrate bony changes roentgenographically in symptomatic patients initially. Bone scans may give earlier evidence for the process.…”

Hypertrophic osteoarthropathy in adults with cystic fibrosis.

“…Grossman, Denning, and Baker (1964) described the occurrence of symptomatic hypertrophic osteoarthropathy in two children (aged 9 and 12) with cystic fibrosis. In their series, three other patients with cystic fibrosis had clubbing and radiographic evidence of osteoarthropathy without bone or joint pains.…”