Hypertrophic osteoarthropathy in a young child with congenital cyanotic heart disease.

Hypertrophic osteoarthropathy in patients with congenital cyanotic heart diseases is extremely rare (Caffey, 1978; Trever, 1958). Of the few cases reported in the world literature, the youngest in which such changes have been seen in congenital cyanotic heart disease is 3½ years (Singh et al, 1972). We present a case of congenital cyanotic heart disease, showing gross changes in all long bones at the age of 2 years. A 2-year-old girl was admitted to Nehru Hospital with low to moderate fever of a month's duration. For about a fortnight preceding admission, she had been complaining of pain in all limbs and particularly in the knee, ankle and elbow joints, severe enough to confine her to bed. Cyanotic congenital heart disease had been diagnosed at the age of 1 year. Recurrent cyanotic spells had necessitated hospitalisation on three earlier occasions and oral propranolol had been prescribed.