Hypertrophic Osteoarthropathy

A review of the classification, pathogenesis, clinical presentation, imaging features, and differential diagnosis of hypertrophic osteoarthropathy.

Course ID: Q00533 Category:
Modalities: , ,


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Radiography: 1.50
Procedures: 1.50
Thorax and Abdomen Procedures: 0.50
Extremity Procedures: 1.00


  1. Introduction
  2. Classification and Nomenclature of HOA
  3. Pathogenesis and Etiology of HOA
    1. Primary HOA
    2. Secondary HOA
  4. Clinical Presentation of HOA
    1. Primary HOA
    2. Secondary HOA
  5. Imaging Features of HOA
    1. Radiography and CT
    2. MR Imaging
    3. Bone Scintigraphy
    4. Positron Emission Tomography
  6. Differential Diagnosis of HOA
    1. Thyroid Acropachy
    2. Variconazole-induced Periostitis
    3. Venous Stasis or Insufficiency
    4. Leukemia and Lymphoma
    5. Hypervitaminosis A
    6. Progressive Diaphyseal Dysplasia
  7. Prognosis and Treatment of HOA
    1. Primary HOA
    2. Secondary HOA
  8. Conclusion


Upon completion of this course, students will:

  1. list the clinical features of hypertrophic osteoarthropathy
  2. state one of the oldest clinical signs of hypertrophic osteoarthropathylist the synonyms for clubbing
  3. indicate when hypertrophic osteoarthropathy was distinguished from acromegaly
  4. identify the male to female ratio of hypertrophic osteoarthropathy
  5. list other names for primary hypertrophic osteoarthropathy
  6. compare the occurrence of secondary hypertrophic osteoarthropathy to primary hypertrophic osteoarthropathy
  7. state the number of models currently in existence that help explain the pathogenesis associated with hypertrophic osteoarthropathy
  8. correlate the relationship of lung functions to secondary hypertrophic osteoarthropathy
  9. explain the histologic contributors to secondary hypertrophic osteoarthropathy
  10. state the most common cause of hypertrophic osteoarthropathy
  11. recall the incidence of hypertrophic osteoarthropathy in lung cancer patients
  12. name the clinical symptom seen in the majority of hypertrophic osteoarthropathy cases
  13. identify the methods to diagnose clubbing
  14. state the digital index necessary to determine clubbing
  15. list the subtypes of pachydermoperiostosis associated with primary hypertrophic osteoarthropathy
  16. recall the most common subtype of primary hypertrophic osteoarthropathy
  17. select the most advanced stage of skin hypertrophy
  18. choose the imaging modality used first to evaluate pain associated with hypertrophic osteoarthropathy
  19. list soft-tissue radiographic findings associated with hypertrophic osteoarthropathy
  20. state where periostosis normally manifests
  21. select the bones most commonly affected by periostosis
  22. list the multiple periosteal reactions in bone
  23. state the signal intensity associated with periosteal reaction as seen on MR T2-weighted images
  24. choose the findings at MR imaging of extremities that can be indistinguishable
  25. identify the imaging modality in which a tram line or double stripe sign can be seen
  26. state the role bone scintigraphy plays in hypertrophic osteoarthropathy
  27. explain how thyroid acropachy usually arises
  28. list the metacarpals affected by thyroid acropachy
  29. state symptoms experienced by patients with Voriconazole-induced periostitis
  30. list the appearance of periosteal reaction in patients with Voriconazole-induced periostitis
  31. know the imaging modality that can definitively show any associated marrow and soft-tissue abnormality involved by tumor
  32. state the origin of Hypervitaminosis A
  33. select the type of bones affected by Hypervitaminosis A
  34. describe progressive diaphyseal dysplasia
  35. list the comorbidities associated with primary hypertrophic osteoarthropathy
  36. recall how primary hypertrophic osteoarthropathy is usually treated
  37. state the prevalence of malignancy in patients with secondary hypertrophic osteoarthropathy
  38. list the surgical options for treating the underlying cause of secondary hypertrophic osteoarthropathy
  39. state causes of multi-focal periostitis