Open Access Publication
Hypertrophic Osteoarthropathy and Digital clubbing in
Lung Adenocarcinoma
By Konstantinos Michalakis, MD
1
Dimitrios-Anestis Moutzouris, MD
2
The Foot and Ankle Online Journal 2 (7): 2
Hypertrophic osteoarthropathy (HOA) is characterized by digital clubbing, tubular bones periostosis and
synovial effusions mostly in the large joints. While HOA can present as primary bone disease, it is often
encountered in lung adenocarcinoma. Although not directly relevant to foot diseases, we believe that the
characteristics of hypertrophic osteoarthropathy should be recognized among podiatrists and in general
physicians involved with hand and foot abnormalities. We believe that the submitted clinical image has
educational value for medical students, residents, and practicing clinicians. The physician should recognize
digital clubbing when evaluating a patient with such a clinical manifestation, shortening the time to diagnosis
and improving the outcome. A case report and discussion is presented describing HOA features.
Key Words: Hypertrophic Osteoarthropathy, digital clubbing
Accepted: June, 2009 Published: July, 2009
This is an Open Access article distributed under the terms of the Creative Commons Attribution License. It permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited. ©The Foot and Ankle Online Journal (www.faoj.org )
ypertrophic osteoarthropathy or HOA is
characterized by digital clubbing, tubular
bones periostosis and synovial effusions
mostly in the large joints. It can be primary or
secondary usually associated with lung cancer and
more often with adenocarcinoma.
1
Case Report
A 62 year-old man presented reporting cough, weight
loss and anorexia during the last 6 months. He stated
also that his fingers “look different”. Medical history
was remarkable for heavy smoking over 30 years. He
was diagnosed with lung adenocarcinoma and HOA.
(Fig. 1)
Address correspondence to: Konstantinos Michalakis ,Corresponding
Author, National Institutes of Health (NIH),
Maryland, Bethesda, USA kostismichalakis@hotmail.com
Tel. +1-3477550420
Fax +30-210-6437781
1
National Institutes of Health, Endocrine Dept, Bethesda, Maryland, USA.
2
Evagelismos General Hospital, Nephrology Clinic, Athens, Greece.
ISSN 1941-6806 doi: 10.3827/faoj.2009.0207.0002
Figure 1 A 62 year-old male with diagnosed lung
adenocarcinoma and associated finger nail clubbing.
© The Foot and Ankle Online Journal, 2009
H