Definition of Clubbing of the fingers or toes:

Clubbing is changes in the areas under and around the toenails and fingernails, and in the nails themselves that may occur with some disorders.

Considerations:

Common symptoms of clubbing:

• The nail beds soften. The nails may seem to "float" instead of being firmly attached.
• The angle that the nail makes with its cuticle increases.
• The last part of the finger may seem large or bulging. It may also be warm and red.
• The nail curves downward, similar to the shape of the round part of an upside-down spoon.

Clubbing can develop quickly, often within weeks. It also can go away quickly when its cause is treated.

Common Causes:

Lung cancer is the most common cause of clubbing. Clubbing often occurs in heart and lung diseases that reduce the amount of oxygen in the blood, such as:

• Heart defects that are present at birth (congenital)
• Chronic lung infections that occur in people with bronchiectasis,cystic fibrosis, or lung abscess
• Infection of the lining of the heart chambers and heart valves (infectious endocarditis), which can be caused by bacteria, fungi, or other infectious substances
• Lung disorders in which the deep lung tissues become swollen and then scarred (interstitial lung disease)

Other causes of clubbing:

• Celiac disease
• Cirrhosis of the liver and other liver diseases
• Dysentery
• Graves disease
• Overactive thyroid gland
• Other types of cancer, including liver, gastrointestinal, Hodgkin's lymphoma

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 usually has symptoms of another condition. Diagnosing 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 clubbing affect the fingers, toes, or both?
• Is it becoming more noticeable?
• Is the skin ever bluish-colored?
• What other symptoms do you have?
• When did you first notice this?

The following tests may be done:

• Arterial blood gas
• Chest CT scan
• Chest x-ray
• Echocardiogram
• EKG
• Pulmonary function tests

There is no treatment for the clubbing itself. The cause of clubbing can be treated, however.