Acro-osteolysis
Updates to Article Attributes
Body
was changed:
Acro-osteolysis (plural: acro-osteolyses) 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.
When there is linear bone resorption of the midshaft of the distal phalanx with a relatively spared terminal tuft, the condition is also referred to as band acro-osteolysis and carries a more limited differential diagnosis.
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, congenital insensitivity to pain
- juvenile chronic arthritis
- dermatomyositis
- vascular occlusion 5
- reactive arthritis 6
- pityriasis rubra pilaris (very rare skin condition) 8
- pachydermoperiostosis 9
Midshaft resorption (band acro-osteolysis)
- polyvinyl chloride (PVC) exposure10
- primary acro-osteolysis: Hajdu-Cheney syndrome
- hyperparathyroidism (also causes terminal tuft resorption)
- scleroderma11 (also causes terminal tuft resorption)
- idiopathic non-familial acro-osteolysis 15
- pyknodysostosis13, 14 (also causes terminal tuft hypoplasia)
- biomechanical in guitar players 11
Single digit
-<p><strong>Acro-osteolysis</strong> (plural: acro-osteolyses) refers to resorption of the distal phalanx. 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>- +<p><strong>Acro-osteolysis</strong> (plural: acro-osteolyses) refers to resorption of the distal phalanx. The <a href="/articles/terminal-tuft">terminal tuft</a> is most commonly affected. 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><p>When there is linear bone resorption of the midshaft of the distal phalanx with a relatively spared terminal tuft, the condition is also referred to as <strong>band acro-osteolysis</strong> and carries a more limited differential diagnosis.</p><h4>Pathology</h4><h5>Multiple digits</h5><h6>Terminal tuft resorption</h6><ul>
-<li><a title="Epidermolysis bullosa" href="/articles/epidermolysis-bullosa">epidermolysis bullosa</a></li>- +<li><a href="/articles/epidermolysis-bullosa">epidermolysis bullosa</a></li>
-<li>insensitivity to pain, e.g. <a href="/articles/leprosy">leprosy</a>, <a title="Congenital insensitivity to pain" href="/articles/congenital-insensitivity-to-pain">congenital insensitivity to pain</a>- +<li>insensitivity to pain, e.g. <a href="/articles/leprosy">leprosy</a>, <a href="/articles/congenital-insensitivity-to-pain">congenital insensitivity to pain</a>
-</ul><h6>Midshaft resorption</h6><ul>-<li>polyvinyl chloride (PVC) exposure</li>- +</ul><h6>Midshaft resorption (band acro-osteolysis)</h6><ul>
- +<li>polyvinyl chloride (PVC) exposure <sup>10</sup>
- +</li>
- +<li>
- +<a title="Scleroderma (musculoskeletal manifestations)" href="/articles/scleroderma-musculoskeletal-manifestations-1">scleroderma</a> <sup>11 </sup>(also causes terminal tuft resorption)</li>
- +<li>idiopathic non-familial acro-osteolysis <sup>15</sup>
- +</li>
- +<li>
- +<a title="Pyknodysostosis" href="/articles/pyknodysostosis">pyknodysostosis</a> <sup>13, 14</sup> (also causes terminal tuft hypoplasia)</li>
- +<li>biomechanical in guitar players <sup>11</sup>
- +</li>
References changed:
- 10. Preston B, Jones K, Grainger R. Clinical Aspects of Vinyl Chloride Disease. Proc R Soc Med. 1976;69(4):284-6. <a href="https://doi.org/10.1177/003591577606900419">doi:10.1177/003591577606900419</a>
- 11. Destouet J & Murphy W. Acquired Acroosteolysis and Acronecrosis. Arthritis Rheum. 1983;26(9):1150-4. <a href="https://doi.org/10.1002/art.1780260914">doi:10.1002/art.1780260914</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/6615566">Pubmed</a>
- 12. Kemp S, Dalinka M, Schumacher H. Acro-Osteolysis. Etiologic and Radiological Considerations. JAMA. 1986;255(15):2058-61. <a href="https://doi.org/10.1001/jama.255.15.2058">doi:10.1001/jama.255.15.2058</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/3485729">Pubmed</a>
- 13. Mills K & Johnston A. Pycnodysostosis. J Med Genet. 1988;25(8):550-3. <a href="https://doi.org/10.1136/jmg.25.8.550">doi:10.1136/jmg.25.8.550</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/3172150">Pubmed</a>
- 14. Ramaiah K, George G, Padiyath S, Sethuraman R, Cherian B. Pyknodysostosis: Report of a Rare Case with Review of Literature. Imaging Sci Dent. 2011;41(4):177-81. <a href="https://doi.org/10.5624/isd.2011.41.4.177">doi:10.5624/isd.2011.41.4.177</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22232728">Pubmed</a>
- 15. Uchiyama T. Band Acro-Osteolysis in a Middle-Aged Woman. BMJ Case Rep. 2019;12(3):e229054. <a href="https://doi.org/10.1136/bcr-2018-229054">doi:10.1136/bcr-2018-229054</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30914415">Pubmed</a>
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