Acro-osteolysis

Changed by Henry Knipe, 3 Feb 2016

Updates to Article Attributes

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Acro-osteolysis refers to resorption of the distal phalanx. The terminal tuft ~~bony erosions~~ is most commonly affected but the shaft of the distal phalanx can also be affected in a few conditions. It is associated with a heterogeneous group of pathological entities and, some of which can be remembered by using the mnemonic PINCH FO.

Pathology

Multiple digits

Terminal tuft resorption

scleroderma ⁴
Raynaud disease: ~~Hajdu-Cheney syndrome~~
psoriatic arthritis
~~hyperparathyroidism~~
~~polyvinyl chloride exposure~~
~~insensitivity to pain~~
~~ergot poisoning~~
thermal injury
- extreme cold: frostbite
- extreme heat: burns, electricity
trauma
hyperparathyroidism
epidermolysis bullosa
porphyria
drugs
- phenytoin (occurs in infants of epileptic mothers treated with phenytoin) ⁷
- ergot poisoning/abuse
insensitivity to pain, e.g. leprosy
juvenile chronic arthritis
dermatomyositis
vascular occlusion ⁵
reactive arthritis⁶
pityriasis rubra pilaris (very rare skin condition) ⁸

Midshaft resorption

polyvinyl chloride exposure
primary acro-osteolysis⁴: Hajdu-Cheney syndrome
hyperparathyroidism (also causes terminal tuft resorption)

Single digit

-<p><strong>Acro-osteolysis</strong> refers to terminal tuft bony erosions. It is associated with a heterogeneous group of pathological entities and, some of which can be remembered by using the mnemonic <a href="/articles/acro-osteolysis-mnemonic">PINCH FO</a>.</p><h4>Pathology</h4><h5>Multiple digits</h5><ul>
+<p><strong>Acro-osteolysis</strong> refers to resorption of the <a href="/articles/distal-phalanx">distal phalanx</a>. The <a href="/articles/terminal-tuft">terminal tuft</a> is most commonly affected but the shaft of the distal phalanx can also be affected in a few conditions. It is associated with a heterogeneous group of pathological entities and, some of which can be remembered by using the mnemonic <a href="/articles/acro-osteolysis-mnemonic">PINCH FO</a>.</p><h4>Pathology</h4><h5>Multiple digits</h5><h6>Terminal tuft resorption</h6><ul>
~~-<a href="/articles/primary-acroosteolysis">primary acroosteolysis</a>: <a href="/articles/hajdu-cheney-syndrome-1">Hajdu-Cheney syndrome</a>~~
+<a href="/articles/scleroderma">scleroderma</a> <sup>4</sup>
+<li><a href="/articles/reynaud-disease">Raynaud disease</a></li>
~~-<li><a href="/articles/hyperparathyroidism">hyperparathyroidism</a></li>~~
~~-<li>polyvinyl chloride exposure</li>~~
~~-<li>insensitivity to pain</li>~~
~~-<li>ergot poisoning </li>~~
~~-<li>extreme cold: <a title="frostbite" href="/articles/frostbite">frostbite</a>~~
+<li>extreme cold: <a href="/articles/frostbite">frostbite</a>
+</li>
+<li>extreme heat: burns, electricity</li>
+</ul>
+</li>
+<li>trauma</li>
+<li><a href="/articles/hyperparathyroidism">hyperparathyroidism</a></li>
+<li>epidermolysis bullosa</li>
+<li>porphyria</li>
+<li>drugs<ul>
+<li>phenytoin (occurs in infants of epileptic mothers treated with phenytoin) <sup>7</sup>
~~-<li>extreme heat: burns</li>~~
+<li>ergot poisoning/abuse</li>
~~-<li><a href="/articles/leprosy">leprosy</a></li>~~
+<li>insensitivity to pain, e.g. <a href="/articles/leprosy">leprosy</a>
+</li>
~~-<li><a href="/articles/reynaud-disease">Raynaud disease</a></li>~~
~~-<a href="/articles/scleroderma">scleroderma</a> <sup>4</sup>~~
+<a href="/articles/reactive-arthritis">reactive arthritis</a> <sup>6</sup>
+</li>
+<li>pityriasis rubra pilaris (very rare skin condition) <sup>8</sup>
+</li>
+</ul><h6>Midshaft resorption</h6><ul>
+<li>polyvinyl chloride exposure</li>
+<li>
+<a href="/articles/primary-acroosteolysis">primary acro-osteolysis</a>: <a href="/articles/hajdu-cheney-syndrome-1">Hajdu-Cheney syndrome</a>
+<li>hyperparathyroidism (also causes terminal tuft resorption)</li>

References changed:

6. Paul Schneiderman, Marc E. Grossman. A Clinician's Guide to Dermatologic Differential Diagnosis, Volume 2. (2006) ISBN: 0415390516 - <a href="http://books.google.com/books?vid=ISBN0415390516">Google Books</a>
7. Stephen G. Davies. Chapman & Nakielny's Aids to Radiological Differential Diagnosis. (2013) ISBN: 9780702051760 - <a href="http://books.google.com/books?vid=ISBN9780702051760">Google Books</a>
8. Liu P & Prete P. Arthritis Associated with Pityriasis Rubra Pilaris. BMJ Case Rep. 2010;2010(aug17 1):bcr1220092565. <a href="https://doi.org/10.1136/bcr.12.2009.2565">doi:10.1136/bcr.12.2009.2565</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22766575">Pubmed</a>

Updates to Synonym Attributes

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