Overview
Clubbing is an abnormality of the fingertips with following features:
- beaked nails
- loss of angle between nail bed and finger
- increased AP width of finger tip
- sponginess of proximal nail bed
Causes
Cardiovascular
Common
- Cyanotic congenital heart disease
- Infective endocarditis
Respiratory
common
- lung cancer (not small cell cancer)
- chronic pulmonary suppuration
- bronchiectasis
- lung abscess
- empyema
- Idiopathic pulmonary fibrosis
- cystic fibrosis
- asbestosis
- pleural mesothelioma or fibroma
uncommon
- Cystic fibrosis
- Asbestosis
- Pleural mesothelioma (benign fibrous type) or pleural fibroma
Other uncommon causes
Gastrointestinal
- Cirrhosis (especially biliary cirrhosis)
- Inflammatory bowel disease
- Coeliac disease
Other
- Thyrotoxicosis
- Familial (usually before puberty) or idiopathic
Rare causes
- Neurogenic diaphragmatic tumours
- Pregnancy
- Secondary hyperparathyroidism
Unilateral clubbing
- Bronchial arteriovenous aneurysm
- Axillary artery aneurysm
Critical Care
Compendium
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