• 1.

    Techner, L and J Oloff-Solomon. :Radiologic review: acro-osteolysis. .J Foot Surg 24::305. ,1985. .

  • 2.

    Gama, C and J Meira. :Occupational Acro-osteolysis. :J Bone Joint Surg 60::86. ,1978. .

  • 3.

    Harzy, T. :Idiopathic phalangeal acro-osteolysis: a case report. .Joint Bone Spine 70::146. ,2003. .

  • 4.

    Rohlfing, BM, CM Basch, and HK Genant. :Acro-osteolysis as the sole skeletal manifestation of rheumatoid vasculitis. .Br J Radiol 50::830. ,1977. .

  • 5.

    Fishco, WD and BJ Roth. :Digital fracture after a flexor tendon transfer for hammertoe repair: a case report. .J Foot Ankle Surg 49::179. ,2010. .

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 6.

    Kemp, SS, MK Dalinka, and HR Schumacher. :Acro-osteolysis: etiologic and radiological considerations. .JAMA 255::2058. ,1986. .

  • 7.

    Markowitz, SS, CJ McDonald, W Fethiere, et al. :Occupational acroosteolysis. Arch Derm 106::219. ,1972. .

  • 8.

    Buerger, L. :The Circulatory Disturbances of the Extremities, Including Gangrene, Vasomotor and Trophic Disorders. ,WB Saunders. ,Philadelphia. ,1924. .

    • Search Google Scholar
    • Export Citation
  • 9.

    Higgins, CB and WG Hayden. :Palmar arteriography in acronecrosis. .Radiology. 119::85. ,1976. .

  • 10.

    Barnhill, RL, CH Nousari, X Xu, et al. : “Vascular Diseases. ,” inLever’s Histopathology of the skin. , edited byElder, DE. , p221. ,Wolters Kluwer Lippincott Williams & Wilkins. ,Philadelphia. ,2009. .

    • Search Google Scholar
    • Export Citation
  • 11.

    DaCruz, DJ, RJ Slade, and W Malone. :Fractures of the distal phalanges. .J Hand Surg 13B::350. ,1988. .

  • 12.

    Bullough, P. :Orthopaedic Pathology, ,4th Ed. ,Mosby. ,New York. ,2004. .

  • 13.

    Destoet, JM and WA Murphy. :Guitar player acro-osteolysis. :Skeletal Radiol 6::275. ,1981. .

  • 14.

    Young, RS, D Bryk, and H Ratner. :Selective phalangeal tuft fractures in a guitar player. .Br J Radiol 50::147. ,1977. .

  • 15.

    Beckenbaugh, RD, T Shives, J Dobyns, et al. :Kienbock’s disease: the natural history of Kienbock’s disease and consideration of lunate fractures. .Curr Orthop Pract 149::98. ,1980. .

    • Search Google Scholar
    • Export Citation
  • 16.

    Lee, RU, KM Woessner, and DA Mathison. :Surfer’s asthma. :Allergy Asthma Proc 30::202. ,2009. .

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 17.

    Burdick, CO. :Surfer’s knots. .JAMA 245::823. ,1981. .

  • 18.

    Turetsky, DB, FS Vines, and DA Clayman. :Surfer’s ear: exostoses of the external auditory canal. .AJNR Am J Neuroradiol 11::1217. ,1990. .

  • 19.

    Bailey, P. :Surfer’s rib: isolated rib fracture secondary to incidental trauma. :Ann Emerg Med 14::346. ,1985. .

  • 20.

    McDanal, CE and B Anderson. :Surfer’s elbow. .Hawaii Med J 36::108. ,1977. .

  • 21.

    Thompson, TP, J Pearce, G Chang, et al. :Surfer’s myelopathy. .Spine 29::353. ,2004. .

  • 22.

    Fabian, RH, KA Norcross, and MB Hancock. :Surfer’s neuropathy. .N Engl J Med 316::555. ,1987. .

Surfer’s Toe: Trauma-Induced Idiopathic Acro-Osteolysis in the Toes of a 46-Year-Old Surfer

A Case Report

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  • 1 Central Coast Pathology Consultants, San Luis Obispo, CA
  • | 2 Western Dermatopathology, San Luis Obispo, CA
  • | 3 MRI of San Luis Obispo, San Luis Obispo, CA
  • | 4 Five Cities Foot Clinic, Arroyo Grande, CA
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Acquired acro-osteolysis (AOL) is defined as the resorption of bone from the tufts or shafts of the terminal phalanges. Acquired acro-osteolysis can manifest as a primary osteolysis syndrome and also appears in a number of disease states including rheumatologic disorders, neuropathic diseases, the result of prolonged exposure to polyvinyl chloride, and in rare cases, as a response to repeated mechanical stress. In this report, a 46-year-old surfer was evaluated for AOL as a complication of sports-related repetitive trauma to the right second and third toes. Radiography showed the bony tips of his right second and third toes had been eroded away. Acquired acro-osteolysis in the surfer’s toes resulted from increased blood flow initiated to repair microdamage caused by repeated trauma to the distal ends of his second and third right toes due to the habitual dragging of the affected toes across a surfboard. The always initial lytic phase of bone repair was magnified by the increased arterial input to warm the extremities after prolonged exposure to cold. At 6-years’ follow-up, the use of a protective bandage while surfing has permitted full regeneration of the affected toes. (J Am Podiatr Med Assoc 102(2): 165–168, 2012)

Corresponding author: Larisa M. Lehmer, MA, 3701 S Higuera St, Suite 200, San Luis Obispo, CA 93401. (E-mail: llehmer@ccpathology.com)