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Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Another cause for periosteal reaction of the long bones is hypertrophic osteoarthropathy, but this tends to be painful. Secondary causes of hypertrophic osteoarthropathy include lung cancer, bronchiectasis and mesothelioma as well as non-pulmonary causes such as inflammatory bowel disease and coeliac disease. The latter causes reversal of the normal jejunoileal fold pattern with increased ileal folds and reduced jejunal folds.
Single best answer (SBA)
Published in Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon, Radiology for Undergraduate Finals and Foundation Years, 2018
Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon
A 46-year-old man, with long-standing bronchiectasis, presents with burning joint pain of the fingers and swelling of the right wrist. On examination there is noted to be bilateral digital clubbing. An X-ray is performed and shows periosteal proliferation of new bone in the distal radius and ulna. The appearances are otherwise normal. What is the most likely diagnosis? Caffey’s disease.Hyperparathyroidism.Hypertrophic osteoarthropathy.Osteoarthritis.Rheumatoid arthritis.
Test Paper 7
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
Hypertrophic osteoarthropathy is caused by many pulmonary and non-pulmonary diseases such as benign and malignant thoracic tumours, chronic infection/inflammation (bronchiectasis and lung abscesses), cyanotic congenital heart disease, inflammatory bowel disease and liver cirrhosis. In HOA, resolution of the radiological findings is only really seen following treatment of the underlying condition.
Recognizing skin conditions in patients with cirrhosis: a narrative review
Published in Annals of Medicine, 2022
Ying Liu, Yunyu Zhao, Xu Gao, Jiashu Liu, Fanpu Ji, Yao-Chun Hsu, Zhengxiao Li, Mindie H. Nguyen
Clubbing (Figure 2(g)) is the incrassation of the soft organization beneath the proximal nail plate, leading to increased curvature of the nails. Diagnostic findings include Lovibond’s angle, and the Schamroth sign [44]. This condition may indicate cyanotic congenital heart disease, pulmonary fibrosis, bronchial carcinoma, inflammatory bowel disease, cirrhosis and thyroid acropachy. Although the underlying mechanism remains elusive, several hypotheses have been proposed, including neurocirculatory reflex, growth hormone and megakaryocyte/platelet clump [45]. It is important to differentiate between clubbing and hypertrophic osteoarthropathy, which may resemble clubbing but is distinguished from clubbing by the presence of a painful nail bed, while clubbing is asymptomatic. Hypertrophic osteoarthropathy is associated with the paraneoplastic syndrome of several malignancies, including primary liver cancer [46].
Primary hypertrophic osteoarthropathy with severe arthralgia identified by gene mutation of SLCO2A1
Published in Modern Rheumatology Case Reports, 2021
Tatsuo Ishizuka, Kei Fujioka, Ichiro Mori, Tomofumi Takeda, Masayuki Fuwa, Takahide Ikeda, Koichiro Taguchi, Hiroyuki Morita, Kazuhiko Nakabayashi, Hironori Niizeki
Primary hypertrophic osteoarthropathy (PHO) or pachydermoperiostosis (PDP) was genetic disorder characterised by clubbed finger, hypertrophy of periostosis and the change of hypertrophic skin and 42 cases had been reported in Japan which was extremely predominant in male patients (Male: Female, 15:1). Mutated SLCO2A1 encoded prostaglandin E2 transport protein (HPDG) had been resulted in excessive PGE2 [1]. Firstly, Uppal et al. reported that mutations of HGPD genes which encodes 15-hydroxyprostaglandin dehydrogenase(15-PGDH) have been identified prostaglandin as the main causative factor of PDP [2,3]. Recent advances in the gene analysis of PDP patients focussed on mutation of solute carrier organic anion transport family member 2A1 (SLCO2A1) has been found in the 4 unrelated PDP patients [1].
Clinical features and radiological findings of 67 patients with SAPHO syndrome
Published in Modern Rheumatology, 2018
Hiroshi Okuno, Munenori Watanuki, Yoshiyuki Kuwahara, Akira Sekiguchi, Yu Mori, Shin Hitachi, Keiki Miura, Ken Ogura, Mika Watanabe, Masami Hosaka, Masahito Hatori, Eiji Itoi, Katsumi Sato
In this study, we reported the clinical features and radiological findings in 67 Japanese patients with SAPHO syndrome. The clinical features were almost the same as those of previous reports. Bone lesions including hyperostosis and osteitis were found clinically and radiographically in the majority of patients with SAPHO syndrome. Diagnosis of SAPHO syndrome is usually based on the proposed criteria by Benhamou et al. [4]. Excluding differential diagnosis, such as infections, bone tumors, bone Paget, and hypertrophic osteoarthropathy, is necessary. Bone biopsies should be performed unless the diagnosis is certain. Elucidation of the causes of bone lesions is significant to understand the pathology of SAPHO syndrome deeply and to develop the treatment for SAPHO syndrome.