Hypertrophic Osteoarthropathy: Clinical and Imaging Features

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Rheumatology

Background:

• Hypertrophic osteoarthropathy (HOA) is a syndrome of digital clubbing, periostosis, and arthritis.
• HOA can be primary (pachydermoperiostosis) or secondary to various conditions, notably malignancies.
• Pulmonary conditions are the most common cause of secondary HOA, historically termed hypertrophic pulmonary osteoarthropathy.

Purpose of the Study:

• To comprehensively review the pathogenesis, classification, causes, and clinical manifestations of HOA.
• To detail the imaging findings of HOA across various modalities.
• To differentiate HOA from other conditions causing multifocal periostitis.

Main Methods:

• Review of existing literature on hypertrophic osteoarthropathy.
• Analysis of imaging characteristics of HOA on radiography, CT, MRI, and bone scintigraphy.
• Comparison of HOA with differential diagnoses including thyroid acropachy and neoplastic causes.

Main Results:

• HOA presents with characteristic digital clubbing, periostosis, and synovial effusions.
• Imaging modalities like radiography, CT, MRI, and bone scintigraphy can detect HOA manifestations.
• Secondary HOA has significant association with malignancy, particularly non-small cell lung cancer.

Conclusions:

• Understanding HOA's primary and secondary causes is crucial for appropriate management and prognosis.
• Radiological findings are key in diagnosing HOA and identifying underlying etiologies.
• Differentiating HOA from other causes of periostitis is essential for accurate diagnosis and treatment.