Pachydermoperiostosis Differential Diagnoses

Updated: May 11, 2019
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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DDx

Diagnostic Considerations

Rosenfeld-Kloepfer syndrome, a variant of pachydermoperiostosis or primary hypertropic osteoarthropathy, is characterized by enlargement of the mandible and/or the maxilla; large hands, feet, nose, lips, and tongue; prominence of the upper part of the forehead; cutis verticis gyrata; and corneal leukoma.

Currarino idiopathic osteoarthropathy is a juvenile incomplete form of pachydermoperiostosis or primary hypertropic osteoarthropathy characterized by eczema and wide cranial sutures. [36]

A variant form of pachydermoperiostosis or primary hypertropic osteoarthropathy restricted to the lower extremities in the absence of digital clubbing or typical skin changes has been described. It affected 3 members of a single family and was characterized by pain, swelling, and hyperhidrosis of both feet. Radiographs revealed bony changes consistent with pachydermoperiostosis or primary hypertropic osteoarthropathy. [37]

Secondary hypertrophic pulmonary osteoarthropathy must be excluded.

Thyroid acropachy may cause diagnostic confusion. Unlike pachydermoperiostosis or primary hypertropic osteoarthropathy, thyroid acropachy is not painful.

Syphilitic periostosis can result in bony changes and symptoms similar to those seen in pachydermoperiostosis or primary hypertropic osteoarthropathy.

Differential Diagnoses