Pulmonary Hypertrophic Osteoarthropathy (Periostitis)

CLUBBING and hypertrophic osteoarthropathy usually reflect disease in the lungs and may present the initial overt signs or symptoms of the primary disorder. The bone changes of hypertrophic osteoarthropathy are always accompanied by the soft-tissue changes of clubbing,1 , 2 but clubbing is usually not accompanied by bone change. Under some concepts of etiology, the osteoarthropathy is regarded as simply an advanced response of tissue to the same stimulus that causes clubbing.3 , 4 This "unified" theory has tended to obscure real differences in clinical significance between the findings of clubbing and hypertrophic osteoarthropathy and to cause a loss of definition of the terms . . .