SECONDARY HYPERTROPHIC OSTEOARTHROPATHY AN UNUSUAL CAUSE OF ARTHRITIS IN CHILDHOOD

Although an uncommon occurrence in childhood, hypertrophic osteoarthropathy secondary to tumors-most commonly to osteogenic sarcoma with pulmonary metastasis-may cause severe joint pain and swelling. The syndrome should be considered in the differential diagnosis of acute arthritis in childhood. Hypertrophic osteoarthropathy secondary to chronic pulmonary suppuration or tumor is rare in childhood ( l) , although digital clubbing alone is com-mon. When fully developed, the syndrome consists of terminal clubbing of digits, roentgenographic evidence of periosteal new bone formation at the distal ends of long bones, arthritis, and profuse sweating. The arthritis may precede clubbing (1) and is sometimes painless. The objective findings consist of soft tissue swelling of large From the Sections of Rheumatology and Hematology, De