Periostitis in hypertrophic osteoarthropathy: relationship to disease duration

Pineda, Carlos; Martı́nez-Lavı́n, Manuel; Goobar, Julio E.; Sartoris, D J; Clopton, Paul; Resnick, D

doi:10.2214/ajr.148.4.773

Cited by 65 publications

(29 citation statements)

References 2 publications

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“…A tape measure was used to determine the mid patella circumferential girth to quantify the improvement of knee joint swelling. As for periostosis, it was assessed according to the sites of involvement (diaphysis, metaphysis, or epiphysis), the type of new bone formation (singer layer, multilayered, or irregular), and overall severity index, graded as mild, moderate, or severe . Other clinical outcomes, including acne, hyperhidrosis, arthralgia, and watery diarrhea, were indicated as present or absent.…”

Section: Methodsmentioning

confidence: 99%

Clinical, Biochemical, and Genetic Features of 41 Han Chinese Families With Primary Hypertrophic Osteoarthropathy, and Their Therapeutic Response to Etoricoxib: Results From a Six-Month Prospective Clinical Intervention

et al. 2017

Journal of Bone and Mineral Research

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Primary hypertrophic osteoarthropathy (PHO) is a rare inherited disease caused by genetic defects in the prostaglandin metabolism pathway; disturbed prostaglandin E (PGE ) catabolism resulting in increased PGE level is suggested in the pathogenesis. Forty-three Han Chinese patients with PHO were studied and 41 of them were treated. Mutations in the HPGD gene, causing hypertrophic osteoarthropathy, primary, autosomal recessive 1 (PHOAR1; OMIM 259100), were identified in seven patients, and mutations in the SLCO2A1 gene, causing hypertrophic osteoarthropathy, primary, autosomal recessive 2 (PHOAR2; OMIM 614441), were identified in 36 patients. Clinical phenotypes of PHO varied, ranging from mild isolated finger clubbing to severe pachydermia and disabling joint swelling, even within families. Circulating PGE metabolism features of PHOAR2 were different from those of PHOAR1. Different frequency and severity of pachydermia between the subgroups were also indicated. A percentage of PHOAR2 patients suffered from gastrointestinal hemorrhage, but this symptom was not observed in the PHOAR1 subgroup. Clinical evidence highlighted the essential role of sex hormones in prostaglandin transporter regulation with respect to PHOAR2 onset, although no significant associations of urinary PGE or PGE-M with sex hormones were identified. Treatment with etoricoxib, a selective cyclooxygenase-2 inhibitor, was proved to be beneficial and safe. We detected its notable efficacy in decreasing urinary PGE levels in the majority of the enrolled patients during 6 months of intervention; clinical phenotypes assessed, including pachydermia, finger clubbing, and joint swelling, were improved. We found no visible evidence of a positive effect of etoricoxib on periostosis; however, significant links between urinary PGE and serum bone turnover markers indicated a potential role of decreased PGE in periostosis management. This is the largest reported cohort of subjects genetically diagnosed with PHO. For the first time, we systematically investigated the biochemical and clinical differences between PHOAR1 and PHOAR2, and prospectively showed the positive efficacy and safety of etoricoxib for PHO patients. © 2017 American Society for Bone and Mineral Research.

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Section: Methodsmentioning

confidence: 99%

Clinical, Biochemical, and Genetic Features of 41 Han Chinese Families With Primary Hypertrophic Osteoarthropathy, and Their Therapeutic Response to Etoricoxib: Results From a Six-Month Prospective Clinical Intervention

et al. 2017

Journal of Bone and Mineral Research

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“…Periostitis is a well-known radiographic feature in hypertrophic osteoarthropathy secondary to congenital cyanotic heart disease, bronchiectasis, and carcinoma of the lung [13]. In these conditions the periosteal new bone deposit appears initially in the proximal and distal diaphyses and in the metaphyseal regions of the long tubular bones, resulting in cortical thickening.…”

Section: Periosteal Reaction: Metabolic Hormonal and Systemic Disordersmentioning

confidence: 99%

Lesions of juxtacortical origin (surface lesions of bone)

et al. 1993

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A large variety of tumor and tumor-like conditions have been shown to originate from the surface of bone (Table 1). Most surface lesions are associated with periosteal reaction. The periosteum is a multipotential membrane. Its cellular composition may give rise to a variety of both neoplasms and tumor-like conditions. To avoid misinterpretation, the orthopedist, radiologist, and pathologist should be familiar with the entire spectrum of surface lesions. A better understanding of the natural history and biological behavior at different lesional maturity stages and correlation of the history with the radiographic and pathological findings is essential to establish the correct diagnosis. A history of injury or blunt trauma is very important. A stress fracture may produce a periosteal reaction acd callus that can be difficult to distinguish from osteosarcoma. In this review article, the authors wish to describe and define each term by its anatomy and radiographic features while discussing the entire spectrum of surface lesions. All the illustrative cases in this review article have been proven histologically.

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“…Periostium thickness and extension correlates with the duration of the disease: in a study on 7 patients affected by lung carcinoma the extension and intensity of periostitis were less marked than among 17 patients with benign conditions (Pineda et al, 1987).…”

Section: Hypertrophic Osteoarthropathy (Hoa)mentioning

confidence: 98%