Articular Manifestations in Pulmonary Diseases

Since the description by Hippocrates in the fifth century B. C. of clubbed fingers occurring in a patient with empyema, there has been recurrent interest in the articular manifestations of thoracic diseases. This interest has been intensified since a report by Craig1in England in 1937 and Van Hazel2in the United States in 1940 describing the joint changes occasionally seen in association with intrathoracic tumors. With the increasing incidence of bronchogenic carcinoma, other reports have appeared in the literature dealing with the articular manifestations as occasionally seen in conjunction with this lesion. A discussion of this condition inevitably involves the term hypertrophic pulmonary osteoarthropathy and just how much this term should include. Although Marie's original definition employed the word osteitis, which precludes simple clubbing that is a proliferative change of the soft tissues about the terminal phalanges, Locke3stated, Marie believes that the hippocratic fingers seen