Health Encyclopedia

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

Clubbing

Considerations

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.

Common Causes

Bronchiectasis
Celiac disease
Cirrhosis
Congenital heart disease (cyanotic type)
- Tetralogy of Fallot
- Total anomalous venous return
- Transposition of the great vessels
- Tricuspid atresia
- Truncus arteriosus
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.

Call your health care provider if

If you notice clubbing, call your health care provider.

What to expect at your health care provider's office

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:

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

Review Date:11/12/2007
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.

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