Causes and Phases of Finger Clubbing
Clubbing of fingers is one of the common findings in general physical examination. Clubbing of fingers refers to progressive changes in the nails secondary to underlying disease causing widening of the nail, downward curling of the nail, increase in the angle between nail and cuticle, and softening of nail beds. The clubbing is usually progressive. It undergoes various phases. These are: Phase I: Increased fluctuation of the ungual bed Phase II: Loss of angle between nail and the cuticle (the normal value is 15 degrees). Phase III: Increase in the convexity of the nail bed. Phase IV: Drumstick appearance of the nail Phase V: Longitudinal striae on nails along with increased thickening of distal phalange The causes of the clubbing can be pulmonary or non-pulmonary. Common pulmonary causes of clubbing are: - Cystic fibrosis - Asbestosis - Lung cancer - Pulmonary fibrosis - Bronchiectasis Common non-pulmonary causes of finger clubbing are: - Hepatic disorders - Hodgkin’s lymphoma - Congenital cardiac anomalies such as tetralogy of Fallot - Grave’s disease - Crohn’s disease Reference: https://www.healthline.com/health/clubbing-of-the-fingers-or-toes#causes https://www.slideshare.net/khushyy/clubbing-54538042 Image courtesy: https://www.verywellhealth.com/clubbing-of-fingers-914776