Hypertrophic osteoarthropathy without radiographic evidence of new bone formation

A 70-year-old man with florid symptoms of hypertrophic osteoarthropathy for over a year presented without radiographic evidence of new bone formation. His symptoms improved after exploratory thoracotomy, but recurred with lesser severity a year later with tumour recurrence on the chest wall. Absence of new bone formation was again demonstrated radiologically as well as by isotope scan.