Clubbing is elevation of the nail and widening of the distal phalanx. You can test it by opposing the two thumbnails and checking for the absence of the normal diamond shape formed by the nails and cuticle (Schamroth sign). The pathophysiology underlying clubbing is not fully understood. Some causes of digital clubbing are listed below:
Secondary Clubbing ▪ Gastrointestinal—Inflammatory bowel disease, cirrhosis, and celiac disease. ▪ Pulmonary—Malignancy, asbestosis, and cystic fibrosis. ▪ Note: clubbing is NOT associated with chronic obstructive pulmonary disease (COPD) as a primary process. If you have a COPD patient with new onset clubbing, you should be concerned for bronchiogenic carcinoma (lung cancer) or another process listed here. ▪ Cardiac—Congenital heart disease, endocarditis, atrioventricular malformations, or fistulas.
Photo and explanation courtesy of: The Color Atlas of Family Medicine
Clubbing is elevation of the nail and widening of the distal phalanx. You can test it by opposing the two thumbnails and checking for the absence of the normal diamond shape formed by the nails and cuticle (Schamroth sign). The pathophysiology underlying clubbing is not fully understood. Some causes of digital clubbing are listed below:
ReplyDeletePrimary Clubbing
▪ Pachydermoperiostosis.
▪ Familial clubbing.
▪ Hypertrophic osteoarthropathy.
Secondary Clubbing
▪ Gastrointestinal—Inflammatory bowel disease, cirrhosis, and celiac disease.
▪ Pulmonary—Malignancy, asbestosis, and cystic fibrosis.
▪ Note: clubbing is NOT associated with chronic obstructive pulmonary disease (COPD) as a primary
process. If you have a COPD patient with new onset clubbing, you should be concerned for bronchiogenic
carcinoma (lung cancer) or another process listed here.
▪ Cardiac—Congenital heart disease, endocarditis, atrioventricular malformations, or fistulas.
Photo and explanation courtesy of: The Color Atlas of Family Medicine