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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study of the clinical and aetiological patterns of finger clubbing and hypertrophic osteoarthropathy was carried out over a 15-year period. 116 patients were studied. Pain is not a common symptom in patients with finger clubbing and osteoarthropathy in Nigerians, contrary to what has been reported in the literature. The cause of finger clubbing is predominantly pulmonary in origin, being responsible in 84 per cent of cases. The commonest cause in bronchiectasis, followed by empyema thoracis, bronchial carcinoma and lung abscess. Among the nonpulmonary causes are infective endocarditis, endomyocardial fibrosis and cirrhosis of liver. Hypertrophic osteoarthropathy is found in 15 cent of the patients with finger clubbing, the commonest cause being carcinoma of the bronchus.
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PMID:The clinical and aetiological pattern of finger clubbing and hypertrophic osteoarthropathy in Nigerians. 50 49

We report 11 cases of bacterial endocarditis with muscular and articular manifestations seen over the past ten years. There was arthralgia in 7 cases, vertebral pain in 7 cases and myalgia in 3 cases. Arthritis consisted of a monoarthritis of the ankle in 2 cases and oligoarthritis in 2 cases. There were also 2 cases of lumbar spondylodiscitis and 1 of finger clubbing in the series. The underlying heart disease was a valvular lesion of the left side of the heart in 10 cases out of 11 and the organism isolated by blood culture was a streptococcus in 9 cases and a staphylococcus in 11. We emphasis the need for early diagnosis and appropriate antibiotic therapy, in the absence of which the course may be fatal in the short term, as it was the case in one of our own patients.
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PMID:[Articular and muscular manifestations of bacterial endocarditis. 11 cases (author's transl)]. 74 39

Three hundred and twenty-seven cases of mesothelioma accepted by a panel of pathologists have been used to construct a clinical picture of the disease. The cases analysed died between 1 January 1960 and 31 December 1969 and consisted of 267 pleural, 37 peritoneal, and 23 cases which could have arisen in either site. Two hundred and sixty-eight were in men and 59 in women and the disease appeared to be the same in women as in men. The mean age at death was 59-37 (+/- SD 9-89) years but ranged from 29 to 88 years. The mode of onset was insidious in all but a few cases and the mean interval before reaching the hospital was 3-39 (+/- SD 4-64) months for pleural and 3-08 (+/- SD 3-22) for peritoneal cases. Patients usually noticed a dull non pleuritic pain first but suffered some breathlessness, lassitude and weight loss by the time they reached hospital. On examination there was little evidence of disease apart from the signs of pleural effusion or thickening or ascites. Clubbing and signs of asbestosis were rare except in the peritoneal cases who more frequently gave an occupational history of heavy exposure and showed the radiological consequences of this. At the time when these patients were investigated diagnostic procedures were unrewarding and many patients were only diagnosed in retrospect. The prognosis was somewhat better for patients shown to have mainly epithelial cell tumours, 17-89 (+/- SD 18-26) months, predominantly spindle cell lesions surviving on the average only 7-98 (+/- SD 8-55) months and mixed tumours 11-3 months. The criteria for the early clinical diagnosis are described with a view of facilitating the search for effective treatment.
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PMID:The clinical aspects of mesothelioma. 94 45

Osteoid osteomas of the distal phalanx of fingers are uncommon. An extensive review of the literature indicates that the diagnosis of osteoid osteoma of the distal phalanx is often delayed for several months to years (average 34.3 months). Pain is the most common finding (92 percent), followed by swelling and clubbing (75 percent). Relief of pain by aspirin was indicated in 10 patients (42 percent). Multiple operations were done in 7 patients prior to the appropriate diagnosis and treatment. A typical case report is presented to illustrate the difficulties in diagnosis and treatment of this benign bone tumor. A better awareness of this tumor may prevent unwanted delays in diagnosis and unnecessary operations.
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PMID:Osteoid osteoma of the distal phalanx of the finger: a diagnostic challenge. 144 96

We describe three patients with unilateral facial pain due to non-metastatic lung cancer and review 11 published cases. Pain, most frequently located on the right side and around the ear, as well as digital clubbing can be clues to an early diagnosis. Compression of the vagus nerve by the tumour or by mediastinal adenopathy is most likely responsible for the facial pain and could play a role in pulmonary osteoarthropathy.
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PMID:Unilateral facial pain as the first symptom of lung cancer: are there diagnostic clues? 162 15

In fourteen patients affected with pachydermoperiostosis (PDP), or primary hypertrophic osteoarthropathy, the efficacy of colchicine (0.5 mg day for one month) versus placebo on the main clinical features of the disease (finger clubbing, arthritis and pachydermia) was evaluated. In addition, in one patient the usefulness of surgical reduction of clubbed fingertips was investigated. Colchicine did not demonstrate any appreciable effect on finger clubbing (expressed in degrees) or pachydermia, while an effect on arthralgia (as evaluated by the Ritchie Index and Pain Scale) was observed. The surgical treatment of clubbed fingertips failed to show a satisfactory and stable reduction of the fingertips; two months after surgery the nail matrix apparently produced new tissue, once again enlarging and deforming the finger. These results suggest that low dose colchicine cannot be considered the drug of first choice for the treatment of PDP, while higher dosages, although effective, are not tolerated because of the severe side effects. An effective medical and surgical treatment for PDP will be found only when the pathogenetic mechanisms of the disease are clarified.
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PMID:The medical and surgical treatment of finger clubbing and hypertrophic osteoarthropathy. A blind study with colchicine and a surgical approach to finger clubbing reduction. 162 78

A 41 year-old female presented with swelling of lower extremities and polyarthralgia involving both knee joints. Physical examination revealed presence of finger clubbing, tenderness and pain-on-motion in knee and foot joints. A chest X-ray film showed a solitary tumor in the right mid-lung field. There were subperiosteal new bone formation and radioisotope accumulation in the legs bilaterally. The clubbing, periostitis and arthritis confirmed a diagnosis of hypertrophic osteoarthropathy. Adenocarcinoma was the biopsy diagnosis of the lung tumor. The characteristic features of hypertrophic osteoarthropathy resolved after surgical resection of the pulmonary lesion followed by chemotherapy. This case demonstrates a typical example of identification of a treatable malignant condition by rheumatic symptoms.
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PMID:[Amelioration of secondary hypertrophic osteoarthropathy following tumor resection in a patient with primary lung cancer]. 194 51

93 children and adolescents with Crohn's disease have been studied. Terminal ileum (25.8%) and ileum and colon (61.3%) were the most common sites of involvement as determined by X-ray examination. The mean age at the time of diagnosis was 13.2 years. A familial incidence of chronic inflammatory bowel disease was found in 12 patients (12.9%). The most common symptoms were: abdominal pain, anorexia, lassitude, diarrhea, loss of weight. Weight below the third percentile, pain on abdominal palpation, anal lesions, mouth ulcers and clubbing of the fingers were the most common clinical signs at the time of diagnosis. Growth retardation (below the third percentile) was present in 22 of 79 children (27.8%) with a mean follow-up of 40 months. 16 patients out of 75 had initial rectal biopsies with histologic changes characteristic of Crohn's disease. 27 patients had surgical treatment; six of them experienced a relapse within a mean period of 26.7 months. Lastly, the authors show that continuous elemental enteral alimentation (CEEA) during 3 weeks induces a remission. CEEA on a longer period is specially targetted to the treatment of growth retardation.
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PMID:[Crohn's disease in children and adolescents]. 286 58

A patient with severe hepatic transplant rejection presented with evidence of hypertrophic osteoarthropathy. The classic triad of clubbing, periostitis, and arthritis was present along with typical radiographic and bone scan findings. A second liver transplant was not successful and the patient died secondary to massive bleeding. Although hypertrophic osteoarthropathy is known to occur rarely in association with chronic liver disease, it has not been reported accompanying liver transplant rejection. This syndrome is to be differentiated from other causes of arthritis and musculoskeletal pain in liver transplant patients and may contribute towards additional morbidity in these patients.
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PMID:Hypertrophic osteoarthropathy associated with a rejected liver transplant. 355 87

A case of hypertrophic osteoarthropathy is described in an 8-year-old child with late-onset agammaglobulinemia, bronchiectasis and clubbing of the fingers and toes. The child presented with pain of recent onset in the legs, ankles, and knees and a diagnosis of hypertrophic osteoarthropathy was made on the basis of the radiologic findings. Therefore the differential diagnosis of bone and joint pain in agammaglobulinemic subjects must take into account hypertrophic osteoarthropathy.
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PMID:Pulmonary hypertrophic osteoarthropathy in a child with late-onset agammaglobulinemia. 716 Apr 8


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