© 2003 Fellowship of Postgraduate Medicine
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Progressive furrowing of skin with digital clubbing
| The first 150 words of the full text of this article appear below. |
The diagnosis is primary hypertrophic osteoarthropathy or pachydermoperiostitis or Touraine-Solente-Gole syndrome. The presence of characteristic facial features with cutis verticis gyrata and advanced clubbing of the digits in the absence of any systemic features suggest the diagnosis. Radiological evidence of periostitis of the involved bones helps in confirmation of the diagnosis.
The radiograph of wrist (see p 541) shows periosteal reaction as shaggy new bone formation around the styloid process of radius. Cortical sclerosis and periosteal thickening are seen along lower ends of the shafts of radius, ulna and metacarpals, proximal and middle phalanges of both hands.
This condition has to be differentiated from the secondary form of hypertrophic osteoarthropathy, which occurs in relation to bronchopulmonary and rarely other visceral malignancies, suppurative lung diseases, and congenital heart diseases. Here, facial features are minimal or absent and the osteoarthropathy and digital clubbing are painful.1,2 Associated systemic features are present.
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- Progressive furrowing of skin with digital clubbing
- A C Inamadar, A Palit, S B Athanikar, V V Sampagavi, N S Deshmukh, and S I Korishetti
Postgrad. Med. J. 2003 79: 541.[Extract] [Full Text] [PDF]
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