Hypertrophic osteoarthropathy associated with congenital heart disease

Abstract

Hypertrophic osteoarthropathy associated with congenital heart disease is a rare entity. This report presents a case of hypertrophic osteoarthropathy associated with tetralogy of fallot. The clinical spectrum is composed of: 1-Periosteal reaction usually localized to the distal ends of long bones and overlying soft tissue neovascularization manifested by warmth, tenderness and edema, 2-Clubbing of fingers which is a constant finding in cyanotic heart disease, 3-Synovitis which is often continuous with the subperiosteal changes. The radiological findings are characteristic. The etiology, pathophysiology and differential diagnosis are briefly discussed. In view of high prevalence of acute rheumatic fever in this country and the difficulties involved in making the diagnosis in the presence of preceding congenital heart disease, we draw physician's attention to this rare entity in order to avoid misdiagnosis and inappropriate management.