Clubbing of the fingers or toes

Alternative names:

clubbing; osteoarthropathy; pulmonary hypertrophic osteoarthropathy

Definition:

A broadening and thickening of the fingers or toes (distal phalanx) with increased lengthwise curvature and curvature of the tip of the nail, with flattening of the angle between the cuticle and nail.

Considerations:

Clubbing is associated with a wide number of diseases, although it is most often noted in diseases of the heart and lungs which cause decreased blood oxygen and skin blueness (cyanosis). Clubbing can also be associated with diseases that cause malabsorption, and diseases of the liver and the gastrointestinal tract.

Common causes:

• congenital heart disease (cyanotic type)
  • tetralogy of Fallot
  • tricuspid atresia
  • transposition of the great vessels
  • total anomalous venous return
  • truncus arteriosus

• atrial myxoma; left
• atrial myxoma; right
• cystic fibrosis
• emphysema
• tuberculosis
• bronchiectasis
• Crohn's disease
• celiac disease
• chronic active hepatitis
• cirrhosis
• lymphoma, Hodgkin's disease

Note: There may be other causes of clubbing. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for clubbing, occurring alone or in combination with other problems.