hypertrophic pulmonary osteoarthropathy
Last reviewed 01/2018
Hypertrophic pulmonary osteoarthropathy is a rare disorder that is associated with severe clubbing.
This disorder is characterised by:
- subperiosteal new bone formation at the distal ends of long bones, metatarsals, metacarpals and proximal phalanges
- symmetrical arthropathy of adjacent joints
- clubbing of the fingers
- gynaecomastia
The patient may complain of dull aching and sometimes swelling of the wrist and ankles.
This syndrome is most commonly seen in patients with bronchogenic carcinoma - 90% of cases are associated with bronchogenic carcinoma, especially peripheral squamous cell tumours - but also:
- other intrathoracic tumours
- chronic lung sepsis
- chronic liver disease
The pain of the symmetrical arthropathy may be helped by vagotomy below the origin of the recurrent laryngeal nerve.