Hypertrophic Pulmonary Osteoarthropathy

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Hypertrophic Pulmonary Osteoarthropathy

(HPOA)

• most often associated with bronchial carcinoma

Presentation

• middle-aged man
• pain and swelling of wrists and ankles
• occasionally other joints involved

Examination

• gross clubbing fingers
• pain at wrists / ankles
• ? gynaecomastia

Investigations

• X-ray hand / forearm / lower leg
  • periosteal new bone formation (onion-skin appearance)
  • distal ends of shafts of
    • radius
    • ulna
    • fibia
    • fibula

Treatment

• NSAIDS

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