Unilateral hypertrophic osteoarthropathy associated with aortobifemoral graft infection.

Stevens, Max A.; Helms, Clyde A.; El‐Khoury, Georges Y.; Chow, Suet Ling Candice

doi:10.2214/ajr.170.6.9609178

Cited by 12 publications

(4 citation statements)

References 3 publications

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“…Prominent tracer uptake in the digits is reflective of digital clubbing (53). Unilateral distribution in an extremity can point to a localized HOA secondary to an arterial graft infection (13). In addition to diagnosis, radionuclide bone scans can also be used to evaluate therapy response, as scintigraphic findings can resolve after treatment of the underlying secondary cause (54).…”

Section: Bone Scintigraphymentioning

confidence: 99%

“…In one case, for example, periostosis and its corresponding scintigraphic changes in the lower extremity resolved after resection of the lung tumor (54). HOA secondary to vascular graft infection is treated by surgical removal of the infected prosthesis and intravenous antibiotic therapy (13). The prognosis of vascular graft infection is reportedly poor, however, with an overall survival of only 58% and a posttreatment complication rate of 57% (11).…”

Section: Secondary Hoamentioning

confidence: 99%

“…Secondary HOA can also be further classified into generalized forms due to systemic diseases and localized forms limited to one or two extremities (Fig 1), usually due to prominent endothelial injury (eg, arterial aneurysm). In addition, HOA may be limited to the cyanotic limb in the setting of a patent ductus arteriosus complicated by pulmonary hypertension, and may manifest unilaterally in the setting of arterial graft infection (11)(12)(13) or a functioning arteriovenous fistula (14).…”

Section: Introductionmentioning

confidence: 99%

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Hypertrophic Osteoarthropathy: Clinical and Imaging Features

Yap¹,

Skalski²,

Patel³

et al. 2017

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Hypertrophic osteoarthropathy (HOA) is a medical condition characterized by abnormal proliferation of skin and periosteal tissues involving the extremities and characterized by three clinical features: digital clubbing (also termed Hippocratic fingers), periostosis of tubular bones, and synovial effusions. HOA can be a primary entity, known as pachydermoperiostosis, or can be secondary to extraskeletal conditions, with different prognoses and management implications for each. There is a high association between secondary HOA and malignancy, especially non-small cell lung cancer. In such cases, it can be considered a form of paraneoplastic syndrome. The most prevalent secondary causes of HOA are pulmonary in origin, which is why this condition was formerly referred to as hypertrophic pulmonary osteoarthropathy. HOA can also be associated with pleural, mediastinal, and cardiovascular causes, as well as extrathoracic conditions such as gastrointestinal tumors and infections, cirrhosis, and inflammatory bowel disease. Although the skeletal manifestations of HOA are most commonly detected with radiography, abnormalities can also be identified with other modalities such as computed tomography, magnetic resonance imaging, and bone scintigraphy. The authors summarize the pathogenesis, classification, causes, and symptoms and signs of HOA, including the genetics underlying the primary form (pachydermoperiostosis); describe key findings of HOA found at various imaging modalities, with examples of underlying causative conditions; and discuss features differentiating HOA from other causes of multifocal periostitis, such as thyroid acropachy, hypervitaminosis A, chronic venous insufficiency, voriconazole-induced periostitis, progressive diaphyseal dysplasia, and neoplastic causes such as lymphoma. RSNA, 2016.

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Section: Bone Scintigraphymentioning

confidence: 99%

Section: Secondary Hoamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hypertrophic Osteoarthropathy: Clinical and Imaging Features

Yap¹,

Skalski²,

Patel³

et al. 2017

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“…Dies wird nicht zuletzt durch die lokalisierten Formen der hypertrophischen Osteoarthropathie deutlich, bei denen es nicht zu Shunts im kleinen Kreislauf kommt. So bilden sich die typischen klinischen Veränderungen zum Beispiel bei Alterationen einer Extremitätenarterie (Aneurysma, Infektion einer Gefäßprothese, lokale Entzün-dung) nur im entsprechenden Versorgungsgebiet aus [12,18,20]. Möglich ist hier, wie auch bei der bakteriellen Endokarditis, die Bildung von Thrombozytenaggregaten an der alterierten Gefäßwand, die sich schließlich lösen und nach distal transportiert werden [4].…”

Section: Hypertrophische Osteoarthropathie Und Thrombozytopenie Bei Bunclassified