X-rays tend to show no abnormalities. Although in most cases there is no permanent damage to the affected joints some have progressed to an erosive arthritis with bone destruction. It is usually found in young adults and has an insidious onset. Pain, which is generally mild at the beginning, may increase to a continuous ache. The clinical picture may vary from a minimally swollen joint to tender, warm, and swollen joints resembling those seen in rheumatoid arthritis.
Symptoms are often worse in cold weather.
HPOA also occurs in a variety of other lung diseases. In CF, it is responsible for finger clubbing, swelling of the ends of the long bones with resulting tenderness, for example those in the forearm, and pain or swelling of large joints like the ankle or knee. In most patients, the joint symptoms are symmetrical, for example affecting both wrists, both knees, and both ankles. X-rays show the periosteum, the tissue covering the bone, elevated from the bone surface and some new bone formation. These x-rays changes may not appear for several months after the clinical signs and pain.