title: Treatment of hypertrophic osteoarthropathy with zoledronic acid: case report and review of the literature.
abstract: OBJECTIVE
  Zoledronic acid (ZA) is rarely used to manage hypertrophic osteoarthropathy (HOA). We report our experience with ZA treatment of a patient with HOA and sarcoidosis who had also undergone lung transplant. We also conducted a literature review of the usefulness of bisphosphonates in HOA.
  
  
  METHODS
  We performed a PubMed literature search using keywords HOA, periostitis, bisphosphonate, ZA, sarcoidosis, and lung transplant. A PRISMA flow diagram is presented to depict the data collection process, and a case is reported.
  
  
  RESULTS
  A 62-year-old woman with bilateral lung transplant as a result of severe pulmonary sarcoidosis developed severe limb pain and inflammatory polyarthritis. HOA was diagnosed in the presence of periostitis with the symptoms. Failure of the refractory bone and joint pain to respond to low doses of prednisone, tramadol, or even pamidronate infusion prompted a trial of a single dose of intravenous ZA. Surprisingly, the pain completely resolved without recurrence. A total of 12 cases of HOA treated with bisphosphonates were retrieved from the literature and reviewed.
  
  
  CONCLUSIONS
  Bisphosphonates are generally effective therapy for HOA-related pain. ZA may be even more efficacious and longer lasting than pamidronate for management of the bone and joint pain associated with HOA irrespective of the underlying disorders.
authors: Department of Rheumatic and Immunologic Diseases, Orthopedic and Rheumatic Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
authors: Bijal A
authors: BA
authors: Jayakar
authors: Abby G
authors: AG
authors: Abelson
authors: Qingping
authors: Q
authors: Yao
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D016040:Lung Transplantation; D008875:Middle Aged; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000188:drug therapy* / Q000209:etiology; D012507:Sarcoidosis / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid