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September 26, 1977

Hypertrophic Osteoarthropathy With Hodgkin's Disease in the Mediastinum

JAMA. 1977;238(13):1400-1401. doi:10.1001/jama.1977.03280140078030

HYPERTROPHIC osteoarthropathy can be secondary to a number of diseases. These are frequently neoplastic in nature. Hodgkin's disease of the thoracic cavity is usually considered in the differential diagnosis. We believe the following case represents a rare case of thoracic Hodgkin's disease in which the initial manifestation was symptomatic hypertrophic osteoarthropathy, which appeared to be a symmetrical polyarthritis.

Report of a Case  In October 1976 a 28-year-old man came to his physician with complaints of pain and stiffness in ankles and knees. Swelling with effusions of both knees and both ankles and 1 to 2+ pitting edema of both shins with tenderness were evident. The grip strength was poor bilaterally. The remaining results of the physical examination as reported to us were normal. Laboratory data at that time revealed an antinuclear antibody titer of 1:32 in a speckled pattern. Despite a lack of substantiation, the presumptive diagnosis of systemic lupus