Progressive Clubbing and Periostosis in Primary Hypertrophic Osteoarthropathy: A Case Report
Keywords:
Primary hypertrophic osteoarthropathy, Pachydermoperiostosis, Clubbing, Periostosis, PachydermiaAbstract
Background: Primary hypertrophic osteoarthropathy (PHO), also known as pachydermoperiostosis, is a rare genetic disorder characterized by the triad of digital clubbing, periostosis of long bones, and pachydermia. It accounts for only 3–5% of all hypertrophic osteoarthropathy cases.
Case Presentation: We report the case of a 22-year-old male who presented with progressive clubbing of the fingers and toes, periosteal new bone formation causing painless bony swelling of multiple joints, and coarsening of facial skin (pachydermia) over two years. There was no evidence of underlying cardiac, pulmonary, or gastrointestinal disease. Imaging revealed diffuse periosteal thickening of the distal long bones. After exclusion of secondary causes, a diagnosis of primary hypertrophic osteoarthropathy was established.
Conclusion: This case highlights the importance of recognizing PHO in young patients with clubbing and periostosis to differentiate it from secondary causes and avoid unnecessary investigations.
J MEDICINE 2026; 27(2): 147-150
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