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Skeletal Radiol (2012) 41:10271028 DOI 10.1007/s00256-011-1317-x
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Hypertrophic osteoarthropathy in a child due to thoracic Hodgkins disease
Eleni E. Drakonaki & K. M. Bradley & Z. A. Khan &
C. Patel & D. J. Wilson
Received: 21 July 2011 /Revised: 28 September 2011 /Accepted: 19 October 2011 /Published online: 18 November 2011 # ISS 2011
Keywords Hodgkins disease . Osteoartropathy. Radiographs . CT
There is periosteal reaction along the shaft of the long bones of the hand and foot, leading to the diagnosis of hypertrophic osteoarthropathy (HPOA), associated with intrathoracic Hodgkins disease.
Discussion
Hypertrophic osteoarthropathy in children is rare and is typically considered to be a sign of pulmonary disease [1 3]. However, it may be related to a variety of inflammatory or neoplastic disorders, including congenital heart diseases, pulmonary or cystic fibrosis, infectious airway disease, chronic liver and inflammatory bowel disease as well as various intrathoracic and gastrointestinal tumours [13]. While up to 90% of HPOA cases are associated with primary or metastatic pulmonary neoplasms in adults,
intrathoracic malignant disease accounts for only 12% of HPOA cases in children [13]. The presence of HPOA has been regarded as a poor prognostic sign, since most of the patients with malignancy and HPOA have showed extensive metastases...