Hypertrophic pulmonary osteoarthropathy

Many synonyms exist for this strange affection : Pierre Marie-Strumpell-Bamberger 's disease, Bamberger-Marie's disease, pseudo-acromegaly.

Clinical symptoms are an hypertrophy of soft tissue of distal limb extremities giving the aspect of club-bed fingers or drumstick fingers or hippocratic fingers, with distal neurovascular manifestations like cyanosis, hyperesthesia or sudation.

Radiography (if ever done) shows typicial periosteal appositions.

A characteristic hyperfixation is observed on bone scintigraphy.

The precise physiopathology of this symptom is not very well known: an ectopic secretion of a substance acting like growth hormone has been proposed.

Outside lung cancer or lung chronic disease, this clinical symptom is observed in a few hemopthies, larynx carcinoma and cyanogen cardiac insuffisiency

Idiopathic forms exist without any underlying known pathology.


Picture courtesy of look4.free website