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For other uses, see Clubbing (disambiguation). Name of Symptom/Sign:
Clubbing
Classifications and external resources | ICD-10 | R68.3 | | ICD-9 | 781.5 | In medicine, clubbing, finger clubbing, or digital clubbing is a deformity of the fingers and fingernails that is associated with a number of diseases, mostly of the heart and lungs. Idiopathic clubbing can also occur. Hippocrates was probably the first to document clubbing as a sign of disease, and the phenomenon is therefore occasionally called Hippocratic fingers. Look up clubbing in Wiktionary, the free dictionary. ...
The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from συμπιπτω meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ...
In medicine, a sign is a feature of disease as detected by the doctor during physical examination of a patient. ...
The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ...
The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ...
The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ...
The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ...
For the chemical substances known as medicines, see medication. ...
This article does not cite any references or sources. ...
For other uses, see Nail. ...
Heart disease is an umbrella term for a number of different diseases which affect the heart and as of 2007 it is the leading cause of death in the United States,[1] and England and Wales. ...
In medicine, pulmonology is the specialty that deals with diseases of the lungs and the respiratory tract. ...
Idiopathic means arising spontaneously or from an obscure or unknown cause. ...
For other uses, see Hippocrates (disambiguation). ...
Signs and diagnosis
 Clubbing of the fingernail. The red line shows the outline of a clubbed nail. Clubbing develops in five steps:[1] Image File history File links Clubbing, drawn on OpenOffice. ...
Image File history File links Clubbing, drawn on OpenOffice. ...
- Fluctuation and softening of the nail bed (increased ballotability)
- Loss of the normal <165° angle ("Lovibond angle") between the nailbed and the fold (cuticula)
- Increased convexity of the nail fold
- Thickening of the whole distal finger (resembling a drumstick)
- Shiny aspect and striation of the nail and skin
Schamroth's test or Schamroth's window test (originally demonstrated by South African cardiologist Dr Leo Schamroth on himself[2]) is a popular test for clubbing. When the distal phalanges of corresponding digits of opposite hands are directly apposed, fingernail to fingernail, a small diamond-shaped "window" is apparent between the nailbeds. If this window is obliterated, the test is positive and clubbing is present. In zootomy, several terms are used to describe the location of organs and other structures in the body of bilateral animals. ...
Bodybuilding In bodybuilding, striations are the tiny grooves of muscle across major muscle groups characteristic of a well-developed body. ...
The phalanges in a human hand The name Phalanges is commonly given to the bones that form fingers and toes. ...
When clubbing is encountered in patients, doctors will seek to identify its cause. They usually accomplish this by obtaining a medical history— particular attention is paid to lung, heart, and gastrointestinal conditions —and conducting a clinical examination, which may disclose associated features relevant to a diagnosis. Additional studies such as a chest x-ray may also be performed. Anamnesis (Greek: αναμνησις = recollection, reminiscence) is a term used in medicine, philosophy, psychoanalysis, and religion. ...
In medicine, physical examination, or clinical examination, is the process by which the physician investigates the body of a patient for signs of disease . ...
Pathophysiology Even though clubbing is a widely recognized symptom of many diseases the physiological mechanism that actually causes clubbing is not well understood. Current understanding is that these diseases cause vasodilation in the distal circulation which leads to hypertrophy of the tissue of the nailbeds and thus to the clubbed fingernails. The blood vessels are part of the circulatory system and function to transport blood throughout the body. ...
Bodybuilder Markus Rühl has marked hypertrophy of skeletal muscle. ...
Other factors that have been implicated are the local effects of growth factors (such as platelet-derived growth factor and hepatocyte growth factor) that are usually sequestrated in the pulmonary capillary bed. Many of the conditions associated with clubbing result in shunting across some of the capillary beds in the pulmonary circulation. This article or section is in need of attention from an expert on the subject. ...
Hepatocyte growth factor is a cytokine. ...
Disease associations Although many diseases are associated with clubbing (particularly lung diseases), the reports are fairly anecdotal. Prospective studies of patients presenting with clubbing have not yet been performed, and hence there is no conclusive evidence of these associations.
Isolated clubbing Clubbing is associated with: Image File history File links Download high resolution version (1572x900, 132 KB) example of clubbing secondary to pulmonary hypertension in a patient with Eisenmengers syndrome taken 10 March 205 by Ann McGrath File links The following pages link to this file: Clubbing ...
Image File history File links Download high resolution version (1572x900, 132 KB) example of clubbing secondary to pulmonary hypertension in a patient with Eisenmengers syndrome taken 10 March 205 by Ann McGrath File links The following pages link to this file: Clubbing ...
In medicine, pulmonary hypertension (PH) is an increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion. ...
- Lung disease:
- Heart disease:
- Gastrointestinal and hepatobiliary:
- Others:
- Hyperthyroidism (thyroid acropachy)[6]
- Familial and racial clubbing and "pseudoclubbing" (people of African descent often have what appears to be clubbing)
- Vascular anomalies of the affected arm such as an axillary artery aneurysm
(in unilateral clubbing) Lung cancer is a disease of uncontrolled cell growth in tissues of the lung. ...
Interstitial lung disease (ILD), also known as diffuse parenchymal lung disease (DPLD), refers to a group of lung diseases (including idiopathic pulmonary fibrosis), affecting the alveolar epithelium, pulmonary capillary endothelium, basement membrane, perivascular and perilymphatic tissues. ...
Tuberculosis (abbreviated as TB for tubercle bacillus or Tuberculosis) is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. ...
Lung abscess is necrosis of the pulmonary tissue and formation of cavities containing necrotic debris or fluid caused by microbial infection. ...
An empyema is a collection of pus within a natural body cavity. ...
In medicine, pulmonary hypertension (PH) is an increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion. ...
For COPD occuring in horses, see recurrent airway obstruction. ...
Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia) or region of the body (tissue hypoxia) is deprived of adequate oxygen supply. ...
Endocarditis is an inflammation of the inner layer of the heart, the endocardium. ...
An atrial myxoma is a non-cancerous tumor in the upper left or right side of the heart. ...
Malabsorption is the state of impaired absorption of nutrients in the small intestine. ...
Categories: | ...
Crohns disease (also known as regional enteritis) is a chronic, episodic, inflammatory condition of the gastrointestinal tract characterized by transmural inflammation (affecting the entire wall of the involved bowel) and skip lesions (areas of inflammation with areas of normal lining between). ...
Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ...
This article or section does not cite its references or sources. ...
For the bird, see Liver bird. ...
Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ...
Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ...
Clubbing associated with other symptoms
HPOA -
Main article: Periosteal reaction
 Bone scan of a patient with Marie-Bamberger syndrome A special form of clubbing is hypertrophic pulmonary osteo-arthropathy, known in continental Europe as Pierre Marie-Bamberger syndrome. (In dogs the condition is known as hypertrophic osteopathy.) This is the combination of clubbing and thickening of periosteum (connective tissue lining of the bones) and synovium (lining of joints), and is often initially diagnosed as arthritis. It is commonly associated with lung cancer. Periosteal new bone formation or periosteal reaction can result from any of a large number of causes. ...
Image File history File links Size of this preview: 422 × 599 pixelsFull resolution‎ (1,500 × 2,130 pixels, file size: 1. ...
Image File history File links Size of this preview: 422 × 599 pixelsFull resolution‎ (1,500 × 2,130 pixels, file size: 1. ...
Drawing shows patient lying on a table that slides under the scanner, a technician operating the scanner, and a monitor that will show images made during the scan. ...
Hypertrophic osteopathy is a bone disease secondary to disease in the lungs. ...
The periosteum is an envelope of fibrous connective tissue that is wrapped around the bone in all places except at joints (which are protected by cartilage). ...
Synovium means with egg, because the (synovial) fluid in joints that have a cavity between the bearing surfaces is like egg-white. ...
Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ...
Primary HOA Primary hypertrophic osteo-arthropathy is HPOA without signs of pulmonary disease. This form has a hereditary component, although subtle cardiac abnormalties can occasionally be found. It is known in continental Europe as the Touraine-Solente-Golé syndrome.
See also - Periosteal reaction for more on HPOA and primary HOA
- Genetic clubbed thumb
Periosteal new bone formation or periosteal reaction can result from any of a large number of causes. ...
A clubbed thumb is a term used to describe the genetic clubbing of one or both thumbs. ...
References - ^ Myers KA, Farquhar DR. The rational clinical examination: does this patient have clubbing? JAMA. 2001;286:341-7. PMID 11466101.
- ^ Schamroth L. Personal experience. S Afr Med J 1976;50:297-300. PMID 1265563.
- ^ Sridhar KS, Lobo CF, Altman RD. Digital clubbing and lung cancer. Chest 1998;114:1535-37. PMID 9872183
- ^ Epstein O, Dick R, Sherlock S (1981). "Prospective study of periostitis and finger clubbing in primary biliary cirrhosis and other forms of chronic liver disease". Gut 22 (3): 203-6. PMID 7227854.
- ^ Naeije R. Hepatopulmonary syndrome and portopulmonary hypertension. Swiss Med Wkly. 2003;133:163-9. PMID 12715285.
- ^ -724565997 at GPnotebook
| Symptoms and signs (R00-R69, 780-789) | Circulatory and
respiratory systems | Tachycardia - Bradycardia - Palpitation - Heart murmur - Epistaxis - Hemoptysis - Cough - abnormalities of breathing (Dyspnea, Orthopnoea, Stridor, Wheeze, Cheyne-Stokes respiration, Hyperventilation, Mouth breathing, Hiccup, Bradypnea, Hypoventilation) - Chest pain - Asphyxia - Pleurisy - Respiratory arrest - Sputum - Bruit/Carotid bruit - Rales | | Digestive system and abdomen | Abdominal pain - Acute abdomen - Nausea - Vomiting - Heartburn - Dysphagia - Flatulence - Burping - Fecal incontinence - Encopresis - Hepatomegaly - Splenomegaly - Hepatosplenomegaly - Jaundice - Ascites - Fecal occult blood - Halitosis | | Skin and subcutaneous tissue | disturbances of skin sensation (Hypoesthesia, Paresthesia, Hyperesthesia) - Rash - Cyanosis - Pallor - Flushing - Petechia - Desquamation - Induration - Diaphoresis | Nervous and
musculoskeletal systems | abnormal involuntary movements (Tremor, Spasm, Fasciculation, Athetosis) - Gait abnormality - lack of coordination (Ataxia, Dysmetria, Dysdiadochokinesia, Hypotonia) - Tetany - Meningism - Hyperreflexia | | Urinary system | Dysuria - Vesical tenesmus - Urinary incontinence - Urinary retention - Oliguria - Polyuria - Nocturia - Extravasation of urine | Cognition, perception,
emotional state and behaviour | Anxiety - Somnolence - Coma - Amnesia (Anterograde amnesia, Retrograde amnesia) - Dizziness/Vertigo - smell and taste (Anosmia, Ageusia, Parosmia, Parageusia) | | Speech and voice | speech disturbances (Dysphasia, Aphasia, Dysarthria) - symbolic dysfunctions (Dyslexia, Alexia, Agnosia, Apraxia, Acalculia, Agraphia) - voice disturbances (Dysphonia, Aphonia) | | General symptoms and signs | Fever (Hyperpyrexia) - Headache - Chronic pain - Malaise - Fatigue - Fainting (Vasovagal syncope) - Febrile seizure - Shock (Cardiogenic shock) - Lymphadenopathy - Edema (Peripheral edema, Anasarca) - Hyperhidrosis (Sleep hyperhidrosis) - Delayed milestone - Failure to thrive - food and fluid intake (Anorexia, Polydipsia, Polyphagia) - Cachexia - Xerostomia - Clubbing | |
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