(BMJ)—A 37-year-old man who inhaled up to 10 cans of compressed gas duster daily presented with a several-week hx of painful, diffusely puffy hands. Hand eval and X-ray were normal 1 month prior. Exam: tender phalanges. X-ray: New periosteal bone on phalanges. Labs: TSH normal; alk phos elevated. What's the dx?
Thyroid acropachy
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Hepatitis C–associated osteosclerosis
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Renal osteodystrophy
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Skeletal fluorosis
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Hypertrophic osteoarthropathy
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