Subperiosteal new bone formation in association with vascular graft sepsis

Hypertrophic osteoarthropathy (HOA) is a clinical and radiologic syndrome that consists of periosteal new bone formation, synovitis, and digital clubbing. Secondary HOA has been reported confined to one or two extremities that are perfused by Dacron grafts that have become infected. Herein we include a report of a vascular graft infection that shares some of the clinical features with HOA and a brief review of pathophysiologic theories. We conclude emphasizing that periostitis and other HOA signs and symptoms may play a role as a clue to support the suspicion of vascular graft infection when confusing and vague clinical features are present.