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March 1957

The Features and Significance of Hypertrophic Osteoarthropathy

Author Affiliations

Oklahoma City; Minneapolis

From the Department of Medicine, University of Oklahoma School of Medicine, and the Medical Service, Veterans Administration Hospital (Dr. Hammarsten); from the Department of Medicine, University of Minnesota Medical School, and the Medical Service, Veterans Administration Hospital (Dr. O'Leary). Present address of Dr. O'Leary: North Central Medical Center, Brainard, Minn.

AMA Arch Intern Med. 1957;99(3):431-441. doi:10.1001/archinte.1957.00260030113012

Introduction  Hypertrophic osteoarthropathy is usually accompanied by clubbed fingers and commonly by arthralgia, bone pain, enlargement of the hands and feet, thickening of the wrists and ankles, and gynecomastia. Although it is relatively common, some physicians are not familiar with the syndrome. Cases are sometimes misdiagnosed as acromegaly, Paget's disease, or rheumatoid arthritis. Marie's1 first case, described in 1890, was originally diagnosed as acromegaly.The diagnosis of hypertrophic osteoathropathy is often made by the roentgenologist. The x-ray appearance of onionskin layers or a thin line of new bone along the distal portions of the long bones is characteristic. The disease takes its name from the enlargement of the bones seen in later stages.In past years, hypertrophic osteoarthropathy was often an incidental finding in cases of pulmonary suppuration. In a review of the world literature up to 1915, Locke 2 collected 144 cases of hypertrophic osteoarthropathy—108 of which were

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