This set of scans was ordered for a patient aged 49 years with a long history of smoking.
The pathology on the chest x-ray is common, but the chest x-ray and the bone scan are connected by a syndrome which is quite rare.
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This patient has hypertrophic pulmonary osteoarthropathy, a rare syndrome defined by the presence of clubbing and periosteal proliferation of the tubular bones.
To see more cases like this, visit Figure 1.