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 …