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Corresponding author at: Department of Trauma-, Orthopedic- and Plastic-Surgery, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
A 64-year-old man suffered of long-standing joint effusions of both knees. Preceding cortisone injections had not led to a decline of effusions. Microbiological analysis of joint aspirate showed no germs. The patient was therefore referred for evaluation of a potential rheumatoid arthritis. Clinical examination confirmed significant effusions in both knees without any external inflammatory signs, other joints were not affected. Radiographs (Fig. 1, panel A) showed no osteoarthritis, but distinct periosteal proliferations (white arrows) of both distal femoral bones. Further diagnostic workup revealed a bronchial carcinoma (Fig. 1, panel B, red arrows).
Fig. 1Radiological diagnostics in a case with joint effusions. Panel A: Radiographs show no osteoarthritis, but distinct periosteal proliferations (white arrows) of both distal femoral bones. Panel B: Computed tomography scan of the thorax revealed a bronchial carcinoma (red arrows).
“Secondary hypertrophic osteoarthropathy” was diagnosed and the patient was referred to thoracic surgery.
Secondary hypertrophic osteoarthropathy (HOA), also known as Marie–Bamberger syndrome, is a rare neoplastic syndrome featuring digital clubbing, periosteal proliferation and synovial effusion of adjacent joints [
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