Infected vascular grafts with aortoenteric fistulae can be difficult to diagnose. We describe an interesting patient who developed hypertrophic osteoarthropathy of the lower extremities. This occurred one year prior to the diagnosis of an infected vascular prosthesis. With definitive surgical therapy, all symptoms of hypertrophic osteoarth ropathy resolved. Patients with arterial prostheses who present with hypertrophic osteoarthropathy should be carefully evaluated for occult graft infections.
References
1.
Dailey FH, Genovese PD and Behnke RH: Patent ductus arteriosis with reversal of flow in adults. Ann Intern Med56:865-882, 1962.
2.
Daumant A., Queneau T., Deplante JP and Bouvier M.: Periostose hypertrophique et varioces des membres inferieurs. Lyon Medical233:1261-65, 1975.
3.
King JO: Localized clubbing and hypertrophic osteoarthropathy due to infection in an aortic prosthesis. Br Med J4:404-5, 1972.
4.
Gibson T., Joye J., Schumacher HR and Agarwal B.: Localized hypertrophic osteoarthropathy with abdominal aortic prosthesis and infection. Ann Intern Med81:556-7, 1974.
5.
Walter RD and Resnick D.: Hypertrophic osteoarthropathy of a lower extremity in association with arterial graft sepsis. AJR137:1059-61, 1981.
6.
Sorin SB, Askari A. and Rhodes RS: Hypertrophic osteoarthropathy of the lower extremities as a manifestation of arterial graft sepsis. Arthritis Rheum23:768-70, 1980.
7.
Stein HB and Little HA: Localized hypertrophic osteoarthropathy in the presence of an abdominal aortic prosthesis. CMAJ118:947-48, 1978.
8.
Gally L. and Arvay N.: Les lesions osseuses dans les troubles circulatoires et trouphiques des membres . J Radiol Electrol Med Nucl31:690, 1950.
9.
Graumann W. and Braband H.: Uber Periostveranderungen bei peripheren Durchblutungstorunger. Fortschr Geb Roentgensr Nuklear Med92:337-42, 1960.
10.
Freeman MH and Tonkin AK: Manifestations of hypertrophic pulmonary osteoarthropathy in patients with carcinoma of the lung. Radiology120:363-65, 1976.
11.
Coury C.: Hippocratic fingers and hypertrophic osteoarthropathy. A study of 350 cases . Br J Dis Chest54:202-9, 1960.