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Hypertrophic pulmonary osteopathy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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.

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