Pulmonary hypertrophy

Introduction Pulmonary hypertrophy refers to the symptoms of swelling, hypertrophy, and pain caused by lung disease in some parts of the body. Common pulmonary hypertrophy is pulmonary hypertrophic osteoarthrosis. Pulmonary hypertrophic osteoarthrosis is a clinical imaging syndrome that includes clubbing (toe), long bone periostitis, and arthritis, most of which are associated with lung disease. More than 70% of the reports are secondary to peripheral lung cancer, and others such as tuberculosis, lung abscess, pneumonia, pleurisy, and mediastinal tumor can be caused.

Cause

The cause of the disease is not fully understood. Most patients are secondary to chronic lung diseases such as lung abscess, bronchiectasis, empyema, tuberculosis, benign or malignant tumors of the lung or mediastinum, congenital heart disease and some hypoxia or blood circulation. Obstacle disease. A small number of patients can be seen in digestive diseases such as ulcer disease, chronic dysentery, chronic enteritis, ulcerative colitis, intestinal tuberculosis, digestive tract cancer, chronic hepatitis and cirrhosis. Occasionally after leukemia, polycythemia vera, nasopharyngeal cancer or hypothyroidism. The pathological changes of bones are mainly characterized by chronic proliferative subperiosteal new bone formation around the tubular bone shaft. Joint synovitis, cartilage destruction can occur joint stiffness.

an examination

Related inspection

CT examination of joint space and soft tissue for joint cavity fluid examination

The patient has clubbing, toe, joint swelling, effusion and pain. The distal extremities often have non-concave edema. The tubular bones of the extremities are thickened, painful, and the temperature is increased. The lesions are mostly symmetrical, and the extra-osseous symptoms of various accompanying diseases. Occasionally, the clavicle, ribs and pelvis are also violated. X-ray photographs can be seen in the symmetry of the bones of the limbs around the backbone of the pelvic submucosal new bone (can reach 3 to 4 layers), neat and smooth as onion skin, and some are lace-like, marrow cavity No change. About 1/3 of the cases have inflammation around the joints, synovitis and erosion of the articular surface and even bone healing, and the joints are stiff. Occasionally seen in the wrist, humerus, skull, spine and scapula, the periosteal hyperplasia is slightly milder than the tubular bone. In the primary or familial cases, in addition to the above, there is a widening of the cranial suture and more intersegmental bone. X-ray signs are the main basis for the diagnosis of this disease.

Differential diagnosis

Need to be identified with the following symptoms:

1, muscle pseudo-hypertrophy: muscle pseudo-hypertrophy is a type of muscular dystrophy. Muscular dystrophy is mainly caused by genetic factors, and in addition to genetic factors, the patient's own genetic mutation can also cause the disease. Clinically, progressive muscle atrophy is the main clinical manifestation. Although many scholars have explored the etiology and pathogenesis of muscular dystrophy, it is still unclear.

2, rheumatoid arthritis: the cause of rheumatoid arthritis is still not very clear, and most of them are currently considered to be human autoimmune diseases, can also be regarded as a chronic syndrome, manifested as non-specific inflammation of the peripheral joints . At this time, the diseased joint and its surrounding tissues are progressively destroyed, and the synovitis is persistent and recurrent, which may lead to destruction of cartilage and bone in the joint, joint dysfunction, and even disability. Vasculitis lesions involve various organs of the body, so this disease is also known as rheumatoid disease. The incidence of rheumatoid arthritis is higher in women than in men, and women are 2 to 3 times more likely than men. The incidence rate in European and American countries is significantly higher than that in Chinese.

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