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    Clubbing of the fingers or toes

    Clubbing

    Clubbing is changes in the areas under and around the toenails and fingernails that occur with some disorders. The nails also show changes.

    Considerations

    Common symptoms of clubbing:

    • The nail beds soften. The nails may seem to "float" instead of being firmly attached.
    • The nails forms a sharper angle with the cuticle.
    • The last part of the finger mayappear large or bulging. It may also be warm and red.
    • The nail curves downward so it looks likethe round part of an upside-down spoon.

    Clubbing can develop quickly, often within weeks. It also can go away quickly when its cause is treated.

    Causes

    Lung cancer is the most common cause of clubbing. Clubbing often occurs in heart and lung diseases that reduce the amount of oxygen in the blood. These may include:

    • Heart defects that are present at birth (congenital)
    • Chronic lung infections that occur in people with bronchiectasis, cystic fibrosis, or lung abscess
    • Infection of the lining of the heart chambers and heart valves (infectious endocarditis). This can be caused by bacteria, fungi, or other infectious substances
    • Lung disorders in which the deep lung tissues become swollen and then scarred (interstitial lung disease)

    Other causes of clubbing:

    • Celiac disease
    • Cirrhosis of the liver and other liver diseases
    • Dysentery
    • Graves disease
    • Overactive thyroid gland
    • Other types of cancer, including liver, gastrointestinal, Hodgkin's lymphoma

    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 clubbingoften has symptoms of another condition. Diagnosing that condition is based on:

    • Family history
    • Medical history
    • Physical exam that looks at the lungs and chest

    The health care provider may ask questions such as:

    • Do you have any trouble breathing?
    • Do you have clubbing of thefingers, toes, or both?
    • When did you first notice this? Do you think it's getting worse?
    • Does the skin ever have a blue color?
    • What other symptoms do you have?

    The following tests may be done:

    • Arterial blood gas
    • Chest CT scan
    • Chest x-ray
    • Echocardiogram
    • EKG
    • Pulmonary function tests

    There is no treatment for the clubbing itself. The cause of clubbing can be treated, however.

    References

    Murray JF, Schraufnagel DE. History and physical examinations. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 17.

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    • Clubbed fingers

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      A Closer Look

        Self Care

          Tests for Clubbing of the fingers or toes

            Review Date: 5/10/2013

            Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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