title: Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy.
abstract: Hypertrophic osteoarthropathy (HOA) is an incompletely understood syndrome characterized by digital clubbing and periosteal proliferation of long bones and it is commonly associated with primary lung tumors. Bone scintigraphy is a sensitive method in detecting HOA and characteristic findings have been reported. We present the case of a man with newly diagnosed non-small cell lung cancer, unremarkable clinical examination and blood tests and no digital clubbing. During disease staging, however, bone scintigraphy showed intense calcaneal cortical proliferation bilaterally without involvement of other parts of the skeleton. Cortical reaction of both calcanei resolved significantly after chemotherapy. This case indicates that HOA may manifest with isolated calcaneal periostitis bilaterally, which is a new addition to the literature.
authors.affiliation: Department of Nuclear Medicine, AHEPA Hospital, Aristotle University Medical School, 1 Stilponos Kyriakidi Str, 546 36, Thessaloniki, Greece. emoral@hol.gr
authors.forename: Efstratios
authors.initials: E
authors.lastname: Moralidis
authors.forename: Georgios
authors.initials: G
authors.lastname: Gerasimou
authors.forename: Athina
authors.initials: A
authors.lastname: Theodoridou
authors.forename: Ilias
authors.initials: I
authors.lastname: Hilidis
authors.forename: Efrosyni
authors.initials: E
authors.lastname: Mylonaki
authors.forename: Anna
authors.initials: A
authors.lastname: Gotzamani-Psarrakou
mesh_terms: D000368:Aged; D002111:Calcaneus / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D010522:Periostitis / Q000150:complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging