27th February 2025

Hypertrophic osteoarthropathy

Thickened skin, excess periosteal bone formation in the extremities and digital clubbing may present in this syndrome that most often occurs secondary to certain lung diseases or as a paraneoplastic phenomenon. The possibility of malignancy as the underlying cause highlights the importance of not mistaking the condition for acromegaly or thyroid acropachy, which present similarly. Treatment of the underlying condition stabilises secondary forms of the disease, with partial or complete resolution sometimes seen.

The rare primary form is inherited in an autosomal dominant fashion and is termed pachydermoperiostosis. This is self-limiting, frequently stabilising approximately a decade after symptom onset.