Hypertrophic osteoarthropathy is a disease that affects only a small number of people. In hypertrophic osteoarthropathy, sections of the diaphyses in the area of the long bones in the limbs swell up. The areas affected by the swelling cause pain. In addition, the toes and fingers of patients suffering from hypertrophic osteoarthropathy widen.
What is Hypertrophic Osteoarthropathy?
In the majority of cases, the disease is triggered by a so-called paraneoplastic syndrome. This type of syndrome may be associated with bronchial carcinoma, which is usually a non-small cell carcinoma. See AbbreviationFinder for abbreviations related to Hypertrophic Osteoarthropathy.
The diaphyses in the area of the extremities are primarily affected by hypertrophic osteoarthropathy. In addition, some of the sick people develop additional joint problems. The feet and hands of those affected may also be disturbed in their motor functions.
Rarely, neurovegetative impairments and the development of a so-called dysproteinemia have been observed in connection with hypertrophic osteoarthropathy. Basically, male patients are more often affected by hypertrophic osteoarthropathy than women. In most cases, the patients are middle-aged.
For hypertrophic osteoarthropathy, there is a large number of different synonyms for the disease. For example, the disease is also called Marie-Bamberger syndrome, Pierre-Marie disease or osteoperiostitis ossificans toxicans.
The first to describe the disease was Bamberger, who intensively studied hypertrophic osteoarthropathy in 1889. In doing so, the doctor discovered that there is a connection between widened toes and fingers and diseases of the heart or lungs. A year later, in 1890, Doctor Marie clearly distinguished hypertrophic osteoarthropathy from so-called acromegaly.
Causes
In principle, there are various causes for the development of hypertrophic osteoarthropathy. In the majority of cases, the disease is triggered by a so-called paraneoplastic syndrome. This type of syndrome may be associated with bronchial carcinoma, which is usually a non-small cell carcinoma.
In addition, hypertrophic osteoarthropathy often occurs with various other diseases. These include, for example, chronic diseases of the heart or lungs, such as pulmonary fibrosis or cystic fibrosis. Hypertrophic osteoarthropathy also sometimes occurs in the context of bronchiectasis. In addition, the disease develops in part in parallel with various diseases of the liver that are associated with dysproteinemia. Finally, some patients have an association with Crohn’s disease.
Research into the causal factors for the development of hypertrophic osteoarthropathy shows that the disease is rarely concentrated in certain families of patients. This fact speaks less for a pronounced genetic component of hypertrophic osteoarthropathy. In some cases, hypertrophic osteoarthropathy is also triggered by tumors in the lungs. In addition, this type of tumor often occurs together with carcinoma of the bronchi.
Symptoms, Ailments & Signs
Hypertrophic osteoarthropathy manifests itself in a number of typical symptoms that occur in the majority of affected patients. As part of the disease, swelling develops, from which pain emanates. In some cases, the diseased areas suffer from circulatory disorders.
The swelling occurs primarily in the long tubular bones and there especially in the so-called diaphyses. In addition, the toes and fingers of people suffering from hypertrophic osteoarthropathy widen noticeably. Early diagnosis of hypertrophic osteoarthropathy is of enormous importance.
Because in some cases the disease is associated with a bronchial carcinoma, which leads to the corresponding symptoms. If the symptoms of hypertrophic osteoarthropathy are recognized early, a premature diagnosis of the carcinoma is possible. In this way, valuable time can be gained and the therapy can be started sooner.
Diagnosis & course of disease
The cooperation of the affected patient is required to diagnose hypertrophic osteoarthropathy. In the case of typical symptoms of the disease, a doctor must be informed quickly, who will make a diagnosis. This usually begins with the anamnesis, during which he asks the patient about the symptoms, how they began and how they developed, as well as their general lifestyle.
In this way, the doctor tries to collect important clues to identify the disease at hand and to make a presumptive diagnosis. The assumptions are substantiated in the second step of the diagnosis, the clinical examination of the patient. The main focus here is on the physical examination of the sick person.
Typical changes in the appearance of the toes and fingers in connection with the pain described clearly indicate hypertrophic osteoarthropathy. Before the diagnosis can be considered certain, a conscientious differential diagnosis must be carried out.
The doctor tries to differentiate the symptoms from chronic diseases of the lungs, such as bronchiectasis or tuberculosis. Inflammatory diseases of the intestine with a chronic course can also be ruled out. The doctor will also check whether there is cirrhosis of the liver.
Complications
This disease primarily causes severe swelling, which in most cases is also associated with pain. These swellings can lead to various limitations in the movement and everyday life of the affected person. The pain can also occur in the form of rest pain and lead to sleeping problems.
Circulation is reduced, so extremities are cold or paralyzed. In the worst case, certain regions can die off completely. Further complications usually arise when a carcinoma is diagnosed late and has already spread to other regions. In this case, the life expectancy of the patient decreases extremely.
The treatment is usually causal and depends on the underlying disease. However, this does not always lead to a positive course of the disease. However, the further sale of the disease depends on the underlying disease and its progress. In many cases there are also psychological problems, so that treatment by a psychologist is also necessary. With early diagnosis and treatment, however, the symptoms can be well limited.
When should you go to the doctor?
Hypertrophic osteoarthropathy is a condition that needs to be treated by a doctor for relief. Swelling of the limbs or the whole body are signs of irregularities as well as the presence of a disorder. If there is additional pain, the person concerned needs medical care. Pain medication should only be taken in consultation with a doctor, as serious side effects can occur. If the range of motion is restricted and the joints can no longer be moved or loaded as usual, a doctor is needed. The changes in mobility can lead to serious consequences and lifelong impairments if left untreated.
If the affected person notices problems with the blood circulation, the symptoms must be clarified by a doctor. If you have cold fingers or toes, a feeling of pressure on your body or discolouration of your skin, consult a doctor. If heart palpitations, dizziness or nausea set in, an examination should take place. If the toes or fingers widen, there is a need for action. The visual changes indicate a condition that needs treatment. Sleep disorders or psychological impairments are further indications that should be investigated. If the symptoms persist for several weeks or months, it is advisable to see a doctor for a check-up.
Treatment & Therapy
The treatment of hypertrophic osteoarthropathy primarily depends on the underlying disease. Prompt treatment of the underlying disease is very important in the majority of cases, since the diseases are often serious. The pain associated with hypertrophic osteoarthropathy is often treated with non-steroidal anti-inflammatory drugs.
Prevention
Since prevention of hypertrophic osteoarthropathy is primarily aimed at the underlying diseases, effective prevention is difficult in practice.
Aftercare
The aftercare of hypertrophic osteoarthropathy often leads to a change in the usual processes and therefore amounts to self-help measures. Accompanying measures can alleviate the symptoms, which has a positive effect on the patient’s quality of life. There are various ways of self-help, which the doctor explains in a direct conversation with the person concerned.
The typical swelling in the foot area and often in other parts of the body causes pain. These can be reduced by taking the appropriate medication. Patients should follow the medical instructions for these drugs exactly to avoid overdosing. Special footwear with orthopedic properties also helps against foot pain. The orthopedist adapts this to individual needs.
The special shoes improve the mobility of those affected. Nevertheless, it cannot be avoided that the sporting activities decrease. However, patients should be careful not to give up the activities completely. Physical activity is good for them, even if the amount is reduced.
With the help of a physiotherapist, an individual exercise program is created that the patients can carry out themselves after detailed instructions. With the exercises, they improve their fitness and feel better as a result. This has a positive effect on the overall well-being and increases the quality of life.
You can do that yourself
Patients with hypertrophic osteoarthropathy are usually limited in their usual everyday life and their quality of life due to the accompanying symptoms. By means of suitable self-help measures, those affected improve their individual well-being, with medical care always playing an important role. The swelling of the feet and other parts of the body often causes pain, so patients take appropriate medication prescribed by the specialist.
Orthopedic footwear, which is individually adapted to the patient’s changed foot, contributes to further mobility. Sporting activities are often limited because of hypertrophic osteoarthropathy, but not completely abandoned. Because a certain amount of physical exercise supports the general state of health and well-being of patients with hypertrophic osteoarthropathy. Together with the patient, a physiotherapist develops suitable exercise sequences, which the person concerned can also carry out independently at home and thus increase or at least maintain their physical fitness.
In general, an underlying disease causes hypertrophic osteoarthropathy, which needs to be diagnosed. As long as this has not happened, the patients stick to a healthy lifestyle agreed with the specialist in terms of nutrition, exercise and the consumption of stimulants. In some cases, this makes it possible to have a positive influence on the still unknown underlying disease.
