18 year old female with cystic fibrosis presents with chronic bilateral knee pain and clinical joint effusions.
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Smooth periosteal reaction is seen affecting the medial aspect of both distal femurs. The bones are osteopaenic for the patient's age, otherwise the study was normal. No joint effusion was radiographically apparent.
In a patient with chronic lung disease, the findings are in keeping with hypertrophic osteoarthropathy, and would explain the patient's chronic pain.