Clubbing

yeah clubbing pergi menari... no! im talking bout finger clubbing. it's a clinical condition. defined by increase in the soft tissue of the distal part of the fingers or toes. clubbing has many causes from different systems.

Cardiovascular
- cyanotic congenital heart disease
- infective endocarditis

Respiratory
- lung carcinoma
- bronchiectasis
- lung abscess
- empyema
- idiopathic pulmonary fibrosis
- cystic fibrosis
- asbestosis
- hypertrophic pulmonary osteoarthropathy

Gastrointestinal
- cirhossis
- inflammatory bowel disease
- coeliac disease

others

- thyrotoxicosis

- secondary hyperparathyroidism

- pregnancy

unilateral clubbing might be caused of bronchial arteiovenous aneurysm or axillary artery aneurysm.

clubbing can also present without any reason (idiopathic)

here's a quick way to remember some of the causes of clubbing:

Congenital heart lesion

Liver cirrhosis

Ulcerative collitis

Bronchiogenic carcinoma

Bronchiectasis

Infective endocarditis

Neoplastic condition

Granulomatous disease

okay so that's the causes for clubbing. how do you check for finger clubbing? inspect the fingernails and toenails from the side to check whether there is any loss of angle between nail bed and finger (hyponychial angle). Schamroth's test is a good way to determine whether one have clubbing or not. when the distal phalanges of corresponding fingers of opposite hands are directly placed opposite each other nail to nail, a small diamond shape should appear in normal people. people with finger clubbing will lose that diamond shape. there are 5 stages of finger clubbing that shows the severity.

1 fluctuation and softening of the nail bed

2 loss of normal angle between nailbed and the fold

3 increased convexity of the nail fold

4 thickening of the whole distal finger (drumstick appearance) <- the easiest to remember

5 shiny aspect and striation of the nail and skin

clubbing is important during system examination and you dont want to forget these stuffs when youre in final med lol. a reminder to myself. hmm what else about clubbing? i guess thats all. weeeeee

credit to Dr. Walter, Mr. Wiki, and encik Talley O'Connor