The Features and Significance of Hypertrophic Osteoarthropathy

Hammarsten, James F.

doi:10.1001/archinte.1957.00260030113012

Cited by 93 publications

(18 citation statements)

References 20 publications

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“…There is also increased thickness of soft tissues in the distal parts of arms and legs, and neurovascular changes in the hands and feet, often with redness of the skin. There are asymmetrical arthritis-like changes in limb joints, sometimes with joint effusions; but the effusions are acellular and not inflammatory [ 106,1071. The affected joints show no signs of inflammatory changes on X-ray [105].…”

Section: Hypertrophic Osteoarthropathy (Hoa)mentioning

confidence: 99%

The aetiology of clubbing and hypertrophic osteoarthropathy

Dickinson

1993

Eur J Clin Investigation

133

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Abstract. The evidence is reviewed for the hypothesis that clubbing and hypertrophic osteoarthropathy are due to the peripheral impaction of megakaryocytes and platelet clumps in the fingers and toes, to which this particulate matter has passed in an axial stream. The normal pulmonary vascular bed retains these large particles, which fragment before entering the systemic circulation. A right-to-left shunt allows them to bypass the pulmonary vascular bed. A preliminary histological report of platelet clumps seen at necropsy in nail bed capillaries of clubbed fingers supports the hypothesis. Platelets contain and release platelet-derived growth factor, whose known effects could explain all the pathological changes in clubbing. In addition to explaining why clubbing should occur in cyanotic congenital heart disease, clubbing in sub-acute bacterial endocarditis and distal to infected arterial grafts and aneurysms can be understood in terms of platelet clumps breaking off valves or arterial walls, and passing distally. Clubbing in liver disease is associated with multiple small pulmonary arteriovenous anastomoses which allow large particles through. Hypertrophic osteoarthropathy probably shares the same mechanism, and is mainly attributable to PDGF release; but there may also be altered platelet function and an additional growth factor derived from the lungs.

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Section: Hypertrophic Osteoarthropathy (Hoa)mentioning

confidence: 99%

The aetiology of clubbing and hypertrophic osteoarthropathy

Dickinson

1993

Eur J Clin Investigation

133

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“…Subsequently, hypertrophic osteoarthropathy has been reported in association with a wide variety of diseases, including neoplasms of the lungs, oesophagus, thymus, and stomach, and intrathoracic Hodgkin's disease (Fischer, Singer, and Feldman, 1964;Shapiro and Zvaifler, 1973). In the pre-antibiotic era, hypertrophic osteoarthropathy was commonly observed in individuals with tuberculosis, bronchiectasis, and empyema (Fischer et al, 1964); Hammarsten and O'Leary, 1957). It has also been reported in patients with inflammatory bowel disease, hepatic cirrhosis, cyanotic congenital heart disease, bacterial endocarditis, and hyperthyroidism (Trever, 1958;Fischer et al, 1964;Stanley and Woodgate, 1971).…”

Section: Case Reportsmentioning

confidence: 99%

“…However, a number of disease states has been associated with hypertrophic osteoarthropathy, including pulmonary diseases (Hammarsten and O'Leary, 1957;Fischer et al, 1964). Each of the patients reported by Grossman and all of our patients with cystic fibrosis had advanced lung disease.…”

Section: Case Reportsmentioning

confidence: 99%

“…Initial evaluation, including joint fluid analysis, failed to yield a diagnosis. Long bone radiographs revealed typical changes of hypertrophic osteoarthropathy, a syndrome characterized by ossifying periostitis of long bones, arthritis, and clubbing (Bamberger, 1889;Hammarsten and O'Leary, 1957). A delay in diagnosis occurred due to lack of awareness of an association between hypertrophic osteoarthropathy and cystic fibrosis in adults.…”

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confidence: 99%

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Hypertrophic osteoarthropathy in adults with cystic fibrosis.

Matthay¹,

Matthay²,

Mills³

et al. 1976

Thorax

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“…One case of DIF associated with HOA including both clubbing and roentgenographic evidence of periosteal new bone growth has been reported (3).…”

mentioning

confidence: 99%

Hypertrophic osteoarthropathy and rheumatoid arthritis. Simultaneous occurrence in association with diffuse interstitial fibrosis

Schechter

Bole

1976

Arthritis & Rheumatism

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A patient is described who was treated with highdose prednisone in an attempt to halt progressive respiratory insufficiency associated with diffuse interstitial fibrosis. On cessation of steroid therapy the patient was noted to have radiologic manifestations of hypertrophic osteoarthropathy (HOA) as well as clinical and laboratory features of rheumatoid arthritis (RA). Subsequently a diffuse vasculitis developed with bowel perforation and sepsis leading to death.The association of digital clubbing with several pulmonary diseases, including diffuse interstitial fibrosis (DIF), is well established (1). Similarly pulmonary disease, especially bronchogenic carcinoma, has been asso-

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The Features and Significance of Hypertrophic Osteoarthropathy

Cited by 93 publications

References 20 publications

The aetiology of clubbing and hypertrophic osteoarthropathy

The aetiology of clubbing and hypertrophic osteoarthropathy

Hypertrophic osteoarthropathy in adults with cystic fibrosis.

Hypertrophic osteoarthropathy and rheumatoid arthritis. Simultaneous occurrence in association with diffuse interstitial fibrosis

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