Whole body diffusion weighted imaging with background suppression in pachydermoperiostosis: a case report


      • Hypertrophic osteoarthropathy can be primary or secondary.
      • Pachydermoperiostosis is the primary form of HOA.
      • Pachydermoperiostosis can be associated with systemic manifestations.
      • WB-DWIBS can be used in systemic processes to detect extent of disease involvement.
      • WB-DWIBS may be useful in pachydermoperiostosis to detect systemic manifestations.


      Hypertrophic osteoarthropathy (HOA) is a disease characterized by abnormal skin findings and bone deformities related to subperiosteal bone formation. The disease can be associated with major systemic manifestations (secondary form) or present with absent or less prominent systemic signs and symptoms (primary form). The primary form is called pachydermoperiostosis (PDP). Whole body diffusion weighted imaging with background suppression (WB-DWIBS) is a magnetic resonance imaging (MRI) technique that has been used to highlight whole body involvement in various entities by suppressing background body signals, and is commonly used in oncologic work-ups. In this paper, we present the case of a 23-year-old male presenting with normocytic anemia and coarse facial features, as well as biological anomalies, and we report the use of WB-DWIBS in establishing the patient's diagnosis of PDP.


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        • Martínez-Lavín M.
        • Matucci-Cerinic M.
        • Jajic I.
        • Pineda C.
        Hypertrophic osteoarthropathy: consensus on its definition, classification, assessment and diagnostic criteria.
        J Rheumatol. 1993 Aug; 20: 1386-1387
        • Friedreich N.
        Hyperostse des gesamten skelettes.
        Virchows Arch. 1868; 43: 83-87
        • Touraine A.
        • Solente G.
        • Gole L.
        Un syndrome osteo-dermopathique : la pachydermie plicaturée avec pachyperiostose des extremités.
        Arch Int Med. 1941; 68: 687-700
        • Düster P.
        Pierre-Marie-bamberger syndrome - a paraneoplastic syndrome of lung cancer - a case report.
        Zentralbl Chir. 2002 Jan; 127: 59-61
        • Poantă L.
        • Parasca I.
        • Fazakas E.
        • Porojan M.
        • Pais R.
        • Boian L.
        Paraneoplastic hypertrophic osteoarthropathy: evaluation at 25 years after pneumectomy.
        Pol Arch Med Wewn. 2009 Sep; 119: 603-606
        • Meyer H.-J.
        • Leifels L.
        • Bach A.G.
        • Surov A.
        Secondary hypertrophic osteoarthropathy caused by non-pleural or pulmonary tumors.
        Medicine (Baltimore). 2017 Sep; 96e7985
        • Ede K.
        • McCurdy D.
        • Garcia-Lloret M.
        Hypertrophic osteoarthropathy in the hepatopulmonary syndrome.
        J Clin Rheumatol Pract Rep Rheum Musculoskelet Dis. 2008 Aug; 14: 230-233
      1. Hypertrophic osteoarthropathy secondary to vascular prosthesis infection: report of 3 cases and review of the literature.
        Medicine (Baltimore). 2006; 85 (May): 191
        • Uppal S.
        • Diggle C.P.
        • Carr I.M.
        • Fishwick C.W.G.
        • Ahmed M.
        • Ibrahim G.H.
        • et al.
        Mutations in 15-hydroxyprostaglandin dehydrogenase cause primary hypertrophic osteoarthropathy.
        Nat Genet. 2008 Jun; 40: 789-793
        • Supradeeptha C.
        • Shandilya S.M.
        • Vikram Reddy K.
        • Satyaprasad J.
        Pachydermoperiostosis - a case report of complete form and literature review.
        J Clin Orthop Trauma. 2014 Mar; 5: 27-32
        • Polan S.
        • Butterworth T.
        Cutis verticis gyrata; a review with report of seven new cases.
        Am J Ment Defic. 1953 Apr; 57: 613-631
        • Aparici C.M.
        • Bains S.
        Hypertrophic osteoarthropathy seen with NaF18 PET/CT bone imaging.
        Clin Nucl Med. 2011 Oct; 36: 928-929
        • Santhosh S.
        • Bhattacharya A.
        • Bhadada S.
        • Kaur R.
        • Singh M.
        • Mittal B.R.
        Three-phase skeletal scintigraphy in pachydermoperiostosis.
        Clin Nucl Med. 2011 Dec; 36: e199-e201
        • Bauer J.
        Hypertrophic osteoarthropathy.
        in: Encyclopedia of diagnostic imaging. first edition. Springer, Berlin, New York, Heidelberg2008: 929-931
        • Kwee T.C.
        • Takahara T.
        • Ochiai R.
        • Nievelstein R.A.J.
        • Luijten P.R.
        Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS): features and potential applications in oncology.
        Eur Radiol. 2008 Sep; 18: 1937-1952
        • Khalil G.
        • Gaspard D.
        • Jreige M.
        • Nawfal G.
        Diffusion-weighted whole-body imaging with background body signal suppression in castleman disease.
        Clin Imaging. 2013 Feb; 37: 185-188
        • Capelastegui A.
        • Astigarraga E.
        • García-Iturraspe C.
        MR findings in pulmonary hypertrophic osteoarthropathy.
        Clin Radiol. 2000 Jan; 55: 72-75
        • Sun X.-F.
        • Wu Q.-J.
        • Bi Y.-L.
        • Hou Y.
        • Li M.-T.
        • Zhang W.
        • et al.
        Primary hypertrophic osteoarthropathy with gastric hypertrophy.
        J Rheumatol. 2011 May; 38: 959-960
        • Ninomiya S.
        • Hara T.
        • Tsurumi H.
        • Kanemura N.
        • Kasahara S.
        • Ogawa Y.
        • et al.
        Myelofibrosis successfully treated with prednisolone in a patient with pachydermoperiostosis.
        Intern Med Tokyo Jpn. 2011; 50: 2207-2211