Hypertrophic osteoarthropathy is classified as either primary (hereditary) or secondary. The primary form usually appears in children or young adults. The secondary form can occur at any age and is most often associated with neoplasms or infectious diseases. In the secondary form, associated diseases are more often intrathoracic than extrathoracic. Hypertrophic osteoarthropathy associated with infectious diseases is often characterized by an insidious development of mild rheumatic complaints over a period of months or years. In contrast, rapid onset and progression of hypertrophic osteoarthropathy with prominent joint pain is often associated with malignant diseases.
Hypertrophic osteoarthropathy (HOA) is a clinical syndrome of clubbing of the fingers and toes, enlargement of the extremities, and painful swollen joints Medical history included chronic obstructive pulmonary disease (emphysema), hypertension, cerebrovascular disease and multinodular goiter. Initial visits to doctors are usually for minor pains in the shoulders and hands Medical history included chronic obstructive pulmonary disease (emphysema), hypertension, cerebrovascular disease and multinodular goiter Diaphyseal expansion in tubular bones and sclerosis of the spongiosa in both appendicular and axial skeletal sites are evident. . Phyllodes tumours are fibroepithelial lesions arising from intralobular breast stroma. Secondary HOA is associated with an underlying pulmonary, cardiac, hepatic, or intestinal disease and often has a more rapid course it is more prevalent in the male; secondary type is a condition with symmetrical osteitis of the four limbs, chiefly localized to the phalanges and the terminal epiphyses of the long bones of the forearm and leg, sometimes extending to the proximal ends of the limbs and the flat bones, and accompanied by dorsal kyphosis and joint
Hypertrophic osteoarthropathy is a disease of the joints and bones . In most cases it develops over a period of time and is essentially symptomless. Initial visits to doctors are usually for minor pains in the shoulders and hands. The term HPOA emphasizes the pulmonary problems that represent a major cause of periostitis, although conditions other than pulmonary disorders may cause HPOA. HPOA is a syndrome in which clubbing of fingers and toes, arthritis, and epriostitis occur. Poorly defined bone outgrowths in the epiphyses of tubular bones and sometimes also in the axial skeleton are especially characteristic of this disease Surgical . About 20% of patients with phyllodes tumours develop distant metastases, and long-term survival in these women is rare. history included a right carotid endarterectomy.
Causes of Hypertrophic Osteoarthropathy
The common causes of Hypertrophic Osteoarthropathy :
Symptoms of Hypertrophic Osteoarthropathy
Some are common symptoms of Hypertrophic Osteoarthropathy :
Treatment of Hypertrophic Osteoarthropathy
Nonsteroidal antiinflammatory drugs (NSAIDs) have been beneficial in reducing discomfort, but not in reversing the condition. Aspirin in modest doses or another NSAID, particularly indomethacin, is frequently effective. A variety of agents that cause vasodilation may prove of value, such as calcium channel-blocking drugs. Analgesics are appropriate. Adrenocortical steroid derivatives can be useful . Radiotherapy to the primary tumor site or to the metastatic lesion, as well as chemotherapy, has relieved joint symptoms. Complete disappearance of hypertrophic osteoarthropathy is described after liver transplantation and after appropriate therapy for empyema, lung abscess, bronchiectasis, pneumonia, and bacterial endocarditis . Resolution of symptoms and signs has been shown to follow simple denervation of the hilum or vagotomy on the same side as the lesion. Thoracotomy without denervation in these studies was ineffective. The most importent of Hypertrophic Osteoarthropathy :
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