Hypertrophic pulmonary osteoarthropathy (HPOA)

Case contributed by RMH Report Writing


Bone pain for investigation.

Patient Data

Age: 60-year-old

Tc 99m MDP bone scan

Modality: Nuclear medicine

Isotope Bone Scan.

Linear areas of increased isotope uptake noted involving both upper and lower limbs involving predominantly the radii and ulna, the distal femoral shafts and both distal tibia and fibulae.

These appearances are characteristic of secondary HPOA

Case Discussion

HPOA has many causes, and bronchogenic carcinoma is one of the commonest causes for this occurrence.

It is also seen in chronic suppurative lung conditions, cyanotic congenital heart disease.

In the abdomen, it is associated with inflammatory bowel disease, coeliac and Whipple's disease.

The diffuse periostitis seen along the diametaphysis of long bones is painful and usually associated with clubbing.

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Case Information

rID: 38529
Case created: 23rd Jul 2015
Last edited: 12th Nov 2016
Tags: rmh, hennessy
Inclusion in quiz mode: Included

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