Idiopathic finger clubbing

This is an example of idiopathic Finger Clubbing

Pulmonary Causes:
Tumour (Bronchial Carcinoma, Mesothelioma), Chronic Pulmonary Sepsis (empyema, lung abscess, bronchiectasis, cystic fibrosis), Fibrosing Alveolitis, Asbestosis, Hypertrophic Pulmonary Osteoarthropathy

NB. Chronic Bronchitis does not cause clubbing.

Cardiac Causes:
Cyanotic Congenital Heart Disease, Infectious Endocarditis

Other Causes:
Idiopathic causes, · Cirrhosis, · Inflammatory Bowel Disease (eg Crohn's Disease, Ulcerative Colitis)

Test performed
· View the nail from the side looking at the nail-bed and nail angle; rock the nail from side to side on the nail-bed
Or
· Place nails back to back; if clubbing is not present, a diamond-shaped area is evident between them. With clubbing, the space is lost (positive Schamroth's sign).

Signs observed
· Increase in the soft tissues of the nail-bed and fingertip, with increased sponginess of the nail-bed
· Loss of angle at base of nail
· Increased transverse curvature of nail
· During the final stages, the whole tip of finger becomes clubbed
· Toes may also be clubbed