fbpx

John L. Lovibond

John Locke ‘Jock’ Lovibond (1907-1954) was an English physician

Lovibond was among the first to offer a criteria for the diagnosis of finger clubbing. In 1938, he defined the ‘‘profile sign’’ of the thumb (Lovibond’s angle as it later became known), as the angle made by the nail as it exits the proximal nailfold. 


Biography
  • Born on May 4, 1907
  • 1929 – BA
  • 1932 – MRCS LRCP
  • 1933 – MA
  • 1934 – MB BCh
  • 1935 – MRCP
  • 1936 – MD
  • 1943 – FRCP
  • Died on May 4, 1954

Medical Eponyms
Lovibond angle (profile sign) [1938]

In 1938, Lovibond was among the first to offer a criteria for the diagnosis of finger clubbing. He defined the ‘profile sign’ of the thumb (Lovibond’s angle), as the angle made by the nail as it exits the proximal nailfold. 

Lovibond reported that a profile sign of greater than 180° could be used to differentiate true clubbing from other conditions such as simple nail curving and paronychia, which retained an angle closer to 160°.

From a perusal of the illustrations it will be seen that the normal nail proceeds from the finger at an obtuse angle of about 160° (Fig. 1). This is peculiarly well seen in the normal thumb. When “curving” is present the fundamental angle between phalanx and nail is undisturbed, but the distal part of the nail is curved downwards, maybe very considerably (Fig. 2)…Clubbing can be differentiated from curving, and, indeed, from other conditions, because even in its mildest form this essential angle is characteristically obliterated (Fig. 3). With gross clubbing the angle at the base of the nail becomes greater than 180°; and projects (Fig. 4). 

Lovibond, 1938
Lovibond angle in clubbing
Lovibond JL. Diagnosis of clubbed fingers. Lancet 1938
  1. Normal finger: showing base angle of nail (usually about 160°).
  2. “Curving” of nail: a variation of the normal. note: Essential base angle is preserved.
  3. Mild clubbing: note: Base angle obliterated. (Clubbed finger-nails may also be curved.)
  4. Gross clubbing: Base of nail projects. note: Diameter of finger at nail base is increased in both dimensions.
  5. Chronic paronychia: Fundamental base angle of nail unaltered.
  6. Heberden’s node: Base angle of nail normal.

It is, unfortunately, never possible to emphasise the minor degrees of organic change, so commonly encountered in disease, without perhaps ruthless dogmatism. This method of describing the deformity that characterises the clubbed finger has proved to be of some value when attempting to explain the condition to students. It is, therefore, hoped that it will be found helpful to the clinician in those many difficult cases that confront him where there are small, yet not less significant, degrees of clubbed fingers.

Lovibond, 1938

Key Medical Contributions

Major Publications

Controversies

References

Biography

Eponymous terms


[cite]


BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.