HYPERTROPHIC OSTEOARTHROPATHY IN STAGING SKELETAL SCINTIGRAPHY FOR LUNG-CANCER

Aim: To assess the prognostic significance of hypertropic osteoarthrop athy (HOA) discovered on routine staging bone scintigraphy in patients with lung cancer. Patients and methods: Between 1989 and 1992 all Tc- 99m-MDP bone scintigrams performed for the staging of bronchogenic car cinoma were reviewed. HOA was diagnosed by the observation of cortical /periosteal increased uptake in the extremities of the long bones. Fol low-up and confirmation of the diagnosis nas obtained by hospital comp uter, histology records, operative records, patient notes and radiolog ical data where available. Results: 164 staging scintigrams for lung c ancer were identified. Twenty-eight patients (17%) were observed to ha ve HOA. Patients with and without HO were well matched for age and sex . There was little difference in the distribution of cell type but the HOA groups has a greater incidence of peripheral tumours. There was n o significant difference in survival between the two groups. Two of th ree long-term survivors had clinically overt HOA and one presented wit h arthralgia. Conclusion: HOA is often seen on skeletal scintigraphy f or staging of lung cancer and has no prognostic significance. The data also support current teaching that a high index of suspicion for HOA, as a cause of arthralgia may lead to early diagnosis of a potentially resectable lung carcinoma.