PVC

Question 1

PVC aka?

Answer 1

Occupational Acro-osteolysis

Question 2

Incidence of PVC acro-osteolysis in those who polymerize the monomer?

Answer 2

1-2%

Question 3

Clinical Sx of PVC?

Answer 3

Initial: Fatigue, asthenia, nervousness, insomnia
Later: raynaud’s with digital pain, numbness, tingling.. leading to “drumstick fingers” and “watch-glass nails”
Also: sclerodaerma-like plaques on the hands, wrists, forearms… Soft tissue nodules, carpal tunnel

Question 4

Radiographic hallmark of PVC?

Answer 4

Osteolysis of terminal phalanges (band-like, possibly combined with tuftal resorption and beveling with osseous fragmentation.. Thumb most common)
May affect other phalanges, SI’s, foot (rarely other places)

Question 5

SI findings in PVC?

Answer 5

When present: Erosion and sclerosis about one or both SI joints.. may mimic sero-

Question 6

If PVC exposure is stopped?

Answer 6

Slow improvement of abnormalities.. scintigraphic studies will show improvment as well

Question 7

PVC etiology?

Answer 7

Likley chemical and mechanical vascular and/or neurologic insult, possibly a predisposing factor as well. Possibly an immune component due to the reynaud’s phenomenon