Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
The features of Hypertrophic pulmunary osteoarthropathy (HPOA) on radionuclide bone scintigraphy have been well described in case reports and small series of patients. The aim of this study was to investigate prospectively the prevalence and distribution of HPOA in a large series of patients with carcinoma of the lung. Two hundred and eleven patients aged 31-89 years (average age 66 years) male 65%. female 35% with biopsy proven carcinoma of the bronchus were examined with bone scintigraphy prior to treatment. Bony metastases were detected in 41 patients (20%) and HPOA in 14 patients (7%). Both metastases and HPOA were found in 2 patients (1%). HPOA was clinically suspected in 7 patients in oniy 4 of whom was it demonstrated on bone scan. Ten patients had HPOA on bone scintigraphy which was not suspected clinically- HPOA, when present, was localized to the tibia (71%), femur (50%), forearm (43%) and humerus (7%). We conclude that HPOA, as judged by features on radionuclide bone scintigraphy will be detected in only a minority of patients with imaging of the distal limbs in patients with carcinoma of the lung, when not previously suspected. The clinical benefit of imaging the distal limbs in such cases is unlikely to justify its introduction as a standard procedure.