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Clubbing of the fingers or toes
Definition
Clubbing is a thickening of the flesh under the toenails and fingernails. The nail curves downward, similar to the shape of the round part of an upside-down spoon.
Alternative Names
Clubbing
Considerations
Clubbing occurs with a wide number of diseases. It is most often found in heart and lung diseases that cause a lower-than-normal amount of oxygen in the blood.
Clubbing may also be due to lung cancer, and diseases of the liver and gastrointestinal tract.
Clubbing may also occur in families. In this case it may not be due to an underlying disease.
Causes
- Chronic lung conditions
- Bronchiectasis
- Cystic fibrosis
- Lung abscess
- Lung cancer
- Pulmonary fibrosis
- Congenital heart disease (cyanotic type)
- Digestive system diseases
- Graves disease or hyperthyroidism
- Other conditions
- Dysentery
- Other types of cancer, including liver, gastrointestinal, Hodgkin's lymphoma
- Subacute endocarditis
- Tuberculosis of the intestines
Home Care
There is no specific treatment for the clubbing itself. Home care depends on the diagnosis.
When to Contact a Medical Professional
If you notice clubbing, call your health care provider.
What to Expect at Your Office Visit
A person with clubbing usually has other symptoms and signs of a specific condition. Diagnosing that condition is based on:
- Family history
- Medical history
- Physical exam that looks at the lungs and chest
Medical history questions may include:
- Do you have any breathing difficulty?
- Does clubbing affect the fingers, toes, or both?
- Is it becoming more noticeable?
- Is the skin ever bluish-colored?
- What other symptoms do you have?
- When did you first notice this?
The following tests may be done:
References
Fitzgerald FT, Murray JF. History and physical examinations. In: Mason RJ, Murray JF, Broaddus CV, Nadel JA, eds. Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: Saunders Elsevier;2005:chap 18.
Spicknall KE. Clubbing: an update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance. J Am Acad Dermatol. 2005;52:1020-1028.
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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