What is the most likely diagnosis? 
              
- 79 year-old male with burning leg pain

                  
              Tc99m  Bone Scan
            
              - Chronic venous insufficiency
- Paget Disease
- Shin splints
- Osteosarcoma
- Hypertrophic osteoarthropathy
Additional Images - Frontal view of both knees
             
              
             
            
               
              Additional Images
               
              
              Frontal view of both knees
              
             
            
              
                  Answer:
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                5. Hypertrophic Osteoarthropathy
              
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              Hypertrophic Osteoarthropathy
              General Considerations
              
                - Clinical syndrome consisting of  clubbing of the fingers and toes
- Painful and swollen joints
- Symmetric periostitis especially involving the tibia and fibula, radius and ulna 
- Most often secondary to an intrathoracic neoplasm or infection
- Primary form is called pachydermoperiostitis
 
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