title: Rheumatologic manifestations of pachydermoperiostosis and preliminary experience with bisphosphonates.
abstract: OBJECTIVE
  Pachydermoperiostosis is manifested by finger clubbing, hypertrophic skin changes, and periosteal bone formation. We describe 5 cases revealed primarily by their rheumatologic manifestations. Also reported are preliminary experiences on the use of intravenous pamidronate as a treatment.
  
  
  METHODS
  This is a retrospective study including the analysis of clinical manifestations, laboratory results and morphological examinations gathered from patients' medical records. We evaluated efficacy of treatment with 1 mg/kg iv pamidronate in the 3 new cases.
  
  
  RESULTS
  Before treatment with iv pamidronate, the patients' global assessment was poor (twice) and very poor (once). The physician's global assessment was poor in 3 patients. After treatment with iv pamidronate, 2 patients had significant improvement. Physician and patient global assessments were very good, good, and moderate. No side effects were observed. All biological variables were within normal ranges at 12 month followup visit.
  
  
  CONCLUSIONS
  Pachydermoperiostosis must be recognized by the rheumatologist, since it can present symptomatically through articular manifestations. When conventional treatment modalities fail, iv pamidronate might be useful.
authors.affiliation: Service de Rhumatologie, Hôpital Roger Salengro, CHU Lille, France.
authors.forename: M H
authors.initials: MH
authors.lastname: Guyot-Drouot
authors.forename: E
authors.initials: E
authors.lastname: Solau-Gervais
authors.forename: B
authors.initials: B
authors.lastname: Cortet
authors.forename: X
authors.initials: X
authors.lastname: Deprez
authors.forename: P
authors.initials: P
authors.lastname: Chastanet
authors.forename: A
authors.initials: A
authors.lastname: Cotten
authors.forename: B
authors.initials: B
authors.lastname: Delcambre
authors.forename: R M
authors.initials: RM
authors.lastname: Flipo
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018771:Arthralgia / Q000209:etiology / Q000473:pathology*; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010004:Osteoarthropathy, Primary Hypertrophic / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D000077268:Pamidronate; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D004164:Diphosphonates; D000077268:Pamidronate