016 - Hypertrophic Pulmonary Osteoarthropathy in Palliative Medicine

This episode examines Hypertrophic Pulmonary Osteoarthropathy (HPO), a rare syndrome often associated with underlying pulmonary malignancies. It outlines HPO's clinical presentation, which includes digital clubbing and painful, swollen joints, emphasizing the importance of differentiating it from metastatic bone pain due to its bilateral and symmetrical nature on bone scans. The text further explores the proposed pathophysiological mechanisms, particularly the roles of vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF). Finally, it discusses treatment strategies, highlighting that addressing the underlying disease is most effective, but also suggesting symptomatic relief options such as bisphosphonates, octreotide, and anti-inflammatory drugs for patients not amenable to primary disease treatment.