Idiopathic Hypertrophic Ostearthropathy: Report of Two Cases in Siblings, with the Elder's Chief Complaint Hydrarthrosis of the Left Knee.

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Hypertrophic osteoarthropathy is a syndrome with the following principal signs: clubbed fingers, periostitis of long bones and arthritis. We observed two brothers with this syndrome. The elder brother complained of hydrarthrosis of the left knee, and their illness was diagnosed as idiopathic hypertrophic osteoarthropathy.Case report: A 26-year-old male noted clubbed fingers when he was about sixteen years old. He had hydrarthrosis of the left knee repeatedly from aged eighteen years. There was nil of note in his past history.Family history: The patient's younger brother is twenty-four years old. He noted clubbed fingers when aged approximately fifteen years old. He has had no knee joint symptoms. An inflammatory reaction was not recognized in the blood examination. Periosteal hypertrophy of long bones in the upper and lower extremities was recognized on X-ray. Abnormal high uptakes of long bone around the knee joint was recognized on bone-scintigraphy.Open synovectomy was performed using the medial parapatellar approach for hydrarthrosis of the left knee.The patient was given 20mg/day of tamoxifen citrate, for six months, and then given 0.5mg/day of colchicine for a month. Despite this treatment the patient's left knee hydrarthrosis has not improved.