Oh Kyung Seo, Lee Seung Young, Min Se-Hee, Ryu Choongun, Shin Hwa-Yong
Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Korea.
Anesth Pain Med (Seoul). 2021 Jul;16(3):290-294. doi: 10.17085/apm.20092. Epub 2021 Jul 5.
Hypertrophic osteoarthropathy (HOA) is a rare clinical condition including an abnormal periosteal reaction in the long bones that causes painful swelling and tenderness of the extremities, digital clubbing, arthritis, synovitis, and joint effusions. Most cases are associated with tumorous conditions and most commonly with lung cancer. HOA has been rarely reported in association with other cancers.
A patient with a history of recurrent renal cell carcinoma was referred to our clinic with bilateral leg pain, knee joint effusion, and arthritis. Simple radiography and bone scintigraphy confirmed a diagnosis of HOA. Oral non-steroidal anti-inflammatory drugs, joint fluid aspiration, and intra-articular injection of pain medications were found to be effective in the management of HOA pain.
HOA prognosis depends on the underlying disease, therefore, cancer treatment is critical. This case demonstrates the need to consider HOA in patients with various malignancies who present with bone or joint pain of the extremities.
肥大性骨关节病(HOA)是一种罕见的临床病症,包括长骨的异常骨膜反应,可导致四肢疼痛性肿胀和压痛、杵状指、关节炎、滑膜炎和关节积液。大多数病例与肿瘤性疾病相关,最常见的是与肺癌相关。HOA与其他癌症相关的报道很少。
一名有复发性肾细胞癌病史的患者因双侧腿痛、膝关节积液和关节炎转诊至我们的诊所。简单的X线摄影和骨闪烁显像确诊为HOA。口服非甾体抗炎药、关节腔穿刺抽液和关节内注射止痛药物被发现对HOA疼痛的治疗有效。
HOA的预后取决于基础疾病,因此,癌症治疗至关重要。本病例表明,对于出现四肢骨或关节疼痛的各种恶性肿瘤患者,需要考虑HOA。