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July 1957

Clubbing and Hypertrophic Osteoarthropathy: Two Unusual Cases

Author Affiliations

West Haven, Conn.

From the Medical Services of the Veterans' Administration Hospital, West Haven, Conn., and Yale University School of Medicine, New Haven, Conn.

AMA Arch Intern Med. 1957;100(1):147-151. doi:10.1001/archinte.1957.00260070161020

Marie,1 in 1890, and Bamberger,2 in 1891, first described the syndrome that bears their name, more widely known as hypertrophic pulmonary osteoarthropathy. Since that time, medical literature has recorded divergent opinions regarding the incidence of this disorder in certain diseases and the relationship of simple digital clubbing to hypertrophic osteoarthropathy.

It is accepted that a variety of common pulmonary lesions, most notably bronchogenic carcinoma, empyema, bronchiectasis, and pulmonary abscess, as well as rarer conditions, such as carcinoma of the thymus 3 and pleural mesothelioma,4 may be associated with the disorder. The recognition of hypertrophic osteoarthropathy becomes of great import when it is realized that it may be the earliest sign of bronchogenic carcinoma. It has been emphasized that osteoarthropathy may precede, by as much as 18 months,5 the pulmonary symptoms of neoplasm of the lung, in contrast to the slowly developing chronic variety associated with suppurative

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