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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
ClubbingConsiderations
Clubbing is associated with a wide number of diseases. It is most often noted 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
- Bronchiectasis
- Celiac disease
- Cirrhosis
- Congenital heart disease (cyanotic type)
- Crohn's disease
- Cystic fibrosis
- Lung abscess
- Lung cancer
- Pulmonary fibrosis
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 generally has other symptoms and signs that define a specific condition. Diagnosis of 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 it affect the fingers, toes, or both?
- Is it becoming more noticeable?
- Is the skin ever bluish-colored?
- What other symptoms are also present?
- When did you first notice this?
The following tests may be done:
- Arterial blood gas
- Chest CT scan
- Chest x-ray
- Echocardiogram
- EKG
- Pulmonary function tests
References
Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed. St. Louis, Mo; WB Saunders; 2005:78-79.
Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000:506.
Spicknall KE. Clubbing: an update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance. J Am Acad Dermatol. 2005;52(6):1020-1028
Reviewed By: Andrew Schriber, M.D., F.C.C.P., Specialist in Pulmonary, Critical Care, and Sleep Medicine, Virtua Memorial Hospital, Mount Holly, New Jersey. Review provided by VeriMed Healthcare Network.
