A 49 year old gentleman presented with intermittent bilateral knee swellingfor the past 37 years and was eventually diagnosed as primary hypertrophicosteoarthropathy after secondary forms were excluded. This case illustratesthat the disease can present during childhood with an insidious onset andprogressively become more severe and that is when medical attention issought. Furthermore, the patient did not voluntarily report his skin changesas he considered the slow progressive changes as normal. We report a case ofprimary hypertrophic osteoarthropathy, its clinical presentation, imagingfindings and therapeutic treatment. It is a rare differential diagnosis forchronic joint pain and swelling.
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