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Test Paper 4
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
There are many causes of HPOA, most of which are pulmonary in origin: intrathoracic malignant tumours, including metastasis, mesothelioma, bronchogenic carcinoma and lymphoma; benign tumours, including benign pleural fibroma, thymoma and pulmonary haemangiomas; chronic pulmonary infection (e.g., bronchiectasis and lung abscesses); and cyanotic congenital heart disease. Extrathoracic causes include ulcerative colitis, Crohn’s disease, Whipple disease, liver disease (e.g., cirrhosis, liver abscesses and primary biliary cirrhosis) and gastric and pancreatic carcinomas. Although asbestosis (i.e., asbestos-induced pulmonary fibrosis) is a known cause of HPOA, pleural plaques are not. Radiological abnormalities most commonly affect the lower limb or forearm bones with cortical thickening and lamellar periosteal proliferation. Hypertrophic pulmonary osteoarthropathy is commonly present in conjunction with finger clubbing. If the underlying condition is treated, then this often quickly leads to remission of their symptoms and about a month later to resolution of the radiological findings.
Musculoskeletal (including trauma and soft tissues)
Published in Dave Maudgil, Anthony Watkinson, The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Dave Maudgil, Anthony Watkinson
The following are causes of secondary hypertrophic pulmonary osteoarthropathy. True or false? Hodgkin’s disease.Biliary atresia.Pachydermoperiostosis.Nasopharyngeal polyposis.Infected aortic grafts.
Immune checkpoint inhibitor-induced inflammatory arthritis: identification and management
Published in Expert Review of Clinical Immunology, 2020
Sandra G. Williams, Arash Mollaeian, James D. Katz, Sarthak Gupta
A broad differential diagnosis should be entertained when evaluating patients with suspected ICI-IIA. Oncology patients are at increased risk for septic arthritis and crystal arthropathies. Many of these patients are older and may have already accrued degenerative joint changes. Medications other than ICIs may predispose to musculoskeletal complications. Musculoskeletal complications from chronic inflammatory diseases such as hypertrophic pulmonary osteoarthropathy and amyloidosis are likely increased in oncology patients. Thus, patients with musculoskeletal complaints including nonspecific complaints such as arthralgia and stiffness/gelling should preferentially be referred to a rheumatologist for comprehensive evaluation.
Acute and chronic non-pulmonary complications in adults with cystic fibrosis
Published in Expert Review of Respiratory Medicine, 2019
Lucile Regard, Clémence Martin, Guillaume Chassagnon, Pierre-Régis Burgel
Hypertrophic pulmonary osteoarthropathy is a rare complication of CF and is usually seen in adults with severe lung disease. Symptoms include clubbing and pain at the distal end of long bones [64]. Treatment is symptomatic and should include NSAIDs and management of pulmonary exacerbations. Bisphosphonates may be considered if initial management fails [143].