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Hypertrophic osteoarthropathy (HOA) is a condition characterised by digital clubbing, polyarthralgias, periostosis, occasionally arthritis,1,2 and cutaneous signs of autonomic disorders (sweating, flushing, blanching).3 HOA is classified as either primary (hereditary or occasionally idiopathic in adults) or secondary (often associated with neoplastic or infectious diseases).4 In the industrialised world, 90% of cases are associated with an underlying malignancy, usually a pulmonary neoplasm,1 but also cardiovascular and gastrointestinal diseases.4 Here, we describe the case of a patient presenting with HOA as the first manifestation of a gastrointestinal stromal tumour (GIST).
A 47 year old white man consulted the rheumatologist in January 2005 with a 2 month history of fatigue and bilateral ankle and knee arthritis. Physical examination was normal, except for arthritis in knees and ankles. Blood and urine routine …
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