- PERIOSTEAL HYPERPLASIA, SEVERE, DIFFUSE, CHRONIC, TIBIAL.
- WYOMING STATE VETERINARY LABORATORY
- Associated lesion: Space-occupying mass in thorax (hypertrophic pulmonary osteoarthropathy; HPOA). This dog had sarcoma metastatic to lungs. Proposed pathogenesis: Excessive vascular endothelial growth factor formation (VEGF)(J Pathol. 2004 Jun;203(2):721-728.) The term “pulmonary” is now sometimes dropped in the human literature, to acknowledge that idiopathic and extra-pulmonary masses, as well as other syndromes, are associated with, and presumably trigger, hypertrophic osteoarthropathy. In people these include pulmonary carcinoma, cyanotic heart disease, diffuse pulmonary diseases, endocarditis, Graves’ disease, and cirrhosis. Finger clubbing is one of the oldest clinical signs in human medicine and sometimes called Hippocratic finger (“water accumulates; the patient has fever and cough; the respiration is fast; the feet become edematous; the nails appear curved and the patient suffers as if he had pus inside… If you put your ear against the chest, you hear it seethe inside like sour wine.” – Hippocrates.