Primary Hypertrophic Osteoarthropathy and successful treatment with Oral Bisphosphonates: A Case Report with Literature Review

• Author Details:   
• G. Ram Gautham Ganesan
• V.R. Ganesan

---

View PDF

Primary hypertrophic osteoarthropathy (PHOA) is a rare syndrome with diverse radiological and clinical features. Though the diagnosis can be easily made on the basis of the classic clinical and radiological features, it is often missed due to its variable presentations. Medical management of this rare condition is mainly palliative and it includes usage of NSAIDS, steroids, tamoxifen citrate, retinoids, octreotides, and bisphosphonates and so on. Each group of drug acts differently, as there are many theories postulated towards cause of joint related symptoms. Recently, high amount of interest has been shown with usage of bisphosphonates, which act by inhibition of osteoclasts, as well as by their action against angiogenesis and against vEGF. Isolated case reports of management of PHOA by intravenous pamidronate and zolidronic acid are available. Very few reports show the effects of oral bisphosphonates in the management of PHOA. Here we present a rare case of PHOA who presented with complaints of joint pain and with thickened lesions over the skin and hyperhidrosis. It was successfully and symptomatically treated with oral alendronate.