Clubbing of the fingers or toes

Alternative names
Clubbing

Definition
Clubbing is a broadening and thickening of the fingers or toes with increased lengthwise curvature of the tip of the nail, and flattening of the angle between the cuticle and nail.

Considerations
Clubbing is associated with a wide number of diseases, although it is most often noted in diseases of the heart and lungs that cause decreased blood oxygen and skin blueness (cyanosis), or lung cancer. Clubbing can also be associated with diseases of the liver and the gastrointestinal tract. It may also occur in families without signifying an underlying disease.

Common Causes

     
  • Congenital heart disease (cyanotic type)       o Tetralogy of Fallot       o Tricuspid atresia       o Transposition of the great vessels       o Total anomalous venous return       o Truncus arteriosus  
  • Cystic fibrosis  
  • Bronchiectasis  
  • Lung abscess  
  • Crohn’s disease  
  • Celiac disease  
  • Cirrhosis  
  • Lung cancer  
  • Pulmonary fibrosis

Home Care
There is no specific treatment for the clubbing itself. Home care depends on the specific diagnosis.

Call your health care provider if

If you notice clubbing, call your health care provider. However, this is a relatively late symptom, and other earlier symptoms have usually occurred that require the attention of your health care provider.

What to expect at your health care provider’s office
A person with clubbing generally has other symptoms and signs (usually heart and lung disease) that, when taken together, define a specific syndrome or condition. Diagnosis of that condition is based on the family history, medical history, and thorough physical evaluation.

Medical history questions documenting clubbing in detail may include:

     
  • When did you first notice this?  
  • Does it affect the fingers, toes, or both?  
  • Has it been becoming more noticeable?  
  • What other symptoms are also present?  
  • Is there any breathing difficulty?  
  • Is the skin ever bluish colored?

The physical examination may include thorough assessment of the chest and breathing.

Diagnostic tests that may be performed are:

     
  • Chest x-ray  
  • Chest CT scan  
  • EKG  
  • Echocardiogram  
  • Arterial blood gas  
  • Pulmonary function tests

After seeing your health care provider, you may want to add a diagnosis related to clubbing to your personal medical record.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.