Related topic: secondary hypertrophic osteoarthropathy
M89.40 – Other hypertrophic osteoarthropathy, unspecified site
88220006 – Pachydermoperiostosis syndrome
Differential Diagnosis & Pitfalls
- Secondary hypertrophic osteoarthropathy (SHO), also called secondary pachydermoperiostosis or Pierre-Marie Bamberger syndrome, is the main differential diagnosis. SHO is most commonly secondary to pulmonary disorders (bronchogenic carcinoma, emphysema, bronchiectasis, lung metastases, Hodgkin disease, pulmonary tuberculosis), though it is also associated with pleural, cardiac, abdominal, and miscellaneous disorders. SHO manifests with digital clubbing similar to that seen in PDP. The associated arthropathy of the large limb joints tends to be more severe and painful than in the primary form. There is also marked proliferative periostosis with cortical thickening at the distal ends of long bones and small bones of the hand and feet. Peripheral neurovascular disorders (local cyanosis, paresthesia) are not uncommon. As a paraneoplastic syndrome, symptoms may regress or disappear with successful therapy of the underlying tumor.
- Syphilitic periostitis
- Lepromatous leprosy
- Thyroid acropachy