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Acro-osteolysis

Changed by Ammar Haouimi, 30 Jun 2018

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Acro-osteolysis refers to resorption of the distal phalanx. The terminal tuft 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
psoriatic arthritis
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 arthritis ⁶
pityriasis rubra pilaris (very rare skin condition) ⁸

pachydermoperiostosis⁹

Midshaft resorption

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

Single digit

+<li>
+<a href="/articles/pachydermoperiostosis">pachydermoperiostosis</a><sup>9</sup>
+</li>

References changed:

9. Resnick D. Acro-Osteolysis in Pachydermoperiostosis. Arch Intern Med. 1981;141(10):1387. <a href="https://doi.org/10.1001/archinte.1981.00340100143036">doi:10.1001/archinte.1981.00340100143036</a>
9. Resnick D. Acro-Osteolysis in Pachydermoperiostosis. Arch Intern Med. 1981;141(10):1387. <a href="https://doi.org/10.1001/archinte.1981.00340100143036">doi:10.1001/archinte.1981.00340100143036</a>
9-Resnick D. Acro-osteolysis in Pachydermoperiostosis. Arch Intern Med. 1981;141(10):1387. doi:10.1001/archinte.1981.00340100143036

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