Primary Hypertrophic Osteoarthropathy

Abstract:
A 31 year old man presented with a 10 year history of progressive finger and toe clubbing, distal limb enlargement, and intermittent pain. Examination revealed digital clubbing (210° nail bed angle), hyperpigmented nail folds, and periosteal tenderness. Radiographs demonstrated bony proliferation at phalangeal tips and periosteal thickening in the tibia/fibula. Systemic evaluations ruled out secondary causes, confirming primary hypertrophic osteoarthropathy a hereditary disorder marked by clubbing, periosteal proliferation, and (in some cases) facial skin changes. Initial NSAID therapy was ineffective; subsequent zoledronic acid infusion resolved symptoms within 2 months.

Abstract:
A 31 year old man presented with a 10 year history of progressive finger and toe clubbing, distal limb enlargement, and intermittent pain. Examination revealed digital clubbing (210° nail bed angle), hyperpigmented nail folds, and periosteal tenderness. Radiographs demonstrated bony proliferation at phalangeal tips and periosteal thickening in the tibia/fibula. Systemic evaluations ruled out secondary causes, confirming primary hypertrophic osteoarthropathy a hereditary disorder marked by clubbing, periosteal proliferation, and (in some cases) facial skin changes. Initial NSAID therapy was ineffective; subsequent zoledronic acid infusion resolved symptoms within 2 months.