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Hypertrophic Osteoarthropathy Associated with Cyanotic Congenital Heart Disease
A Report of Two Cases
- GEORGE E. MCLAUGHLIN, M.D.;
- DANIEL J. MCCARTY, JR., M.D., F.A.C.P.; and
- D. F. DOWNING, M.D., F.A.C.P.
- Requests for reprints should be addressed to Daniel J. McCarty, Jr., M.D., Hahnemann Hospital, 230 N. Broad St., Philadelphia, Pa. 19102.
Excerpt
Hypertrophic osteoarthropathy associated with cyanotic congenital heart disease is a rare, poorly understood, but well-documented entity. Trever (1) reported 2 cases in 1958 and cited an incidence of 0.1% in a series of 3,000 cases of cyanotic heart disease. The clinical picture includes periosteal new bone formation, usually localized to the distal ends of the long bones, and overlying soft tissue neovascularization manifested by warmth, tenderness, and edema. When hypertrophic osteoarthropathy is associated with cyanotic congenital heart disease, clubbing of the digits has been a constant finding. The presence of synovitis, noted at necropsy in five of six cases of
Acknowledgments
Grateful acknowledgment is extended to the following individuals: H. E. Holling, M.D., and David Naide, M.D., Robinette Foundation, Hospital of the University of Pennsylvania, Philadelphia, who generously performed venous occlusion plethysmography on both patients; Allan Erslev, M.D., Cardeza Foundation, Jefferson Medical College and Hospital, Philadelphia, who kindly performed the blood viscosity determinations; Harold Rawnsley, M.D., Department of Pathology, University of Pennsylvania School of Medicine, who kindly performed the immunoelectrophoretic studies.
Article and Author Information
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From the Rheumatology Section, Department of Medicine, Hahnemann Medical College and Hospital, Philadelphia, Pa.
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This study was supported in part by grant AM5201-05, National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Md.
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Dr. McLaughlin is a Trainee in Rheumatology, Hahnemann Medical College and Hospital, under grant AM5201-05. Dr. McCarty is a Markle Scholar in Academic Medicine.
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- Received February 13, 1967.
- Accepted March 14, 1967.
