Hypertrophic Osteoathropathy without Pachyderma in a Nigerian: A Case Report

Hypertrophic osteoathropathy is characterized by triad of digital clubbing, periostosis, and pachyderma. We report the case of a young male Nigerian with asymptomatic idiopathic digital clubbing with neither skin changes nor periosteal reaction. He presented to our hospital with swelling of fingers and toes of about six years’ duration. All his fingers and toes were clubbed with drumstick appearance, no swelling or tenderness of the wrists, elbows, ankles or knees and no skin changes. The laboratory findings were normal. Primary hypertrophic osteoathropathy without pachydermia was entertained when neither skin changes nor periostosis were found. Although primary hypertrophic osteoathropathy without skin involvement is rare, effort should be made to search for secondary causes.