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Hypertrophic osteoarthropathy is characterized primarily by clubbing of the fingers or toes accompanied by periosteal proliferation of the tubular bones. This condition is often associated with underlying pulmonary diseases, particularly lung cancer and chronic hypoxia. The clubbing refers to the enlargement of the distal phalanges, resulting in a bulbous appearance of the fingertips, while periosteal proliferation involves new bone formation at the surface of existing bones, which can be visualized through imaging studies. These features highlight the systemic nature of the condition and its link to broader underlying pathologies.

Other choices involve features that do not accurately represent hypertrophic osteoarthropathy. For example, asymmetrical and painless swelling refers more to conditions like osteoarthritis or different forms of inflammatory arthritis. Bone density increase might be observed in various conditions such as Paget's disease, but it is not a hallmark of hypertrophic osteoarthropathy. Lastly, inflammation of synovial joints aligns more with rheumatic diseases rather than the characteristics of hypertrophic osteoarthropathy, which primarily affects the bones and does not typically involve joint inflammation.