摘要:A 49 year old gentleman presented with intermittent bilateral knee swelling for the past 37 years and was eventually diagnosed as primary hypertrophic osteoarthropathy after secondary forms were excluded. This case illustrates that the disease can present during childhood with an insidious onset and progressively become more severe and that is when medical attention is sought. Furthermore, the patient did not voluntarily report his skin changes as he considered the slow progressive changes as normal. We report a case of primary hypertrophic osteoarthropathy, its clinical presentation, imaging findings and therapeutic treatment. It is a rare differential diagnosis for chronic joint pain and swelling.