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    Fingers Clubbing - : COPD Does Not Cause Clubbing !!!!!!!!!!!

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    YzLim
    Clubbing, also known as digital clubbing or drumstick fingers, refers to changes in the appearance of the fingers and toes. It involves the rounding of the fingernails and loss of the angle between the nailbed and finger. Clubbing can be either primary due to genetic conditions or secondary due to underlying diseases. Common causes of secondary clubbing include lung diseases like cancer or fibrosis, heart conditions, gastrointestinal issues, and other miscellaneous diseases. Doctors use objective criteria like nailbed measurements and positioning tests to assess and diagnose clubbing.

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    Fingers Clubbing - : COPD Does Not Cause Clubbing !!!!!!!!!!!

    Uploaded by

    YzLim
    71 views4 pages
    Clubbing, also known as digital clubbing or drumstick fingers, refers to changes in the appearance of the fingers and toes. It involves the rounding of the fingernails and loss of the angle between the nailbed and finger. Clubbing can be either primary due to genetic conditions or secondary due to underlying diseases. Common causes of secondary clubbing include lung diseases like cancer or fibrosis, heart conditions, gastrointestinal issues, and other miscellaneous diseases. Doctors use objective criteria like nailbed measurements and positioning tests to assess and diagnose clubbing.

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    MBBS MD short notes

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    Fingers Clubbing

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    Clubbing, also known as digital clubbing or drumstick fingers, refers to changes in the appearance of the fingers and toes. It involves the rounding of the fingernails and loss of the angle between the nailbed and finger. Clubbing can be either primary due to genetic conditions or secondary due to underlying diseases. Common causes of secondary clubbing include lung diseases like cancer or fibrosis, heart conditions, gastrointestinal issues, and other miscellaneous diseases. Doctors use objective criteria like nailbed measurements and positioning tests to assess and diagnose clubbing.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    71 views4 pages

    Fingers Clubbing - : COPD Does Not Cause Clubbing !!!!!!!!!!!

    Uploaded by

    YzLim
    Clubbing, also known as digital clubbing or drumstick fingers, refers to changes in the appearance of the fingers and toes. It involves the rounding of the fingernails and loss of the angle between the nailbed and finger. Clubbing can be either primary due to genetic conditions or secondary due to underlying diseases. Common causes of secondary clubbing include lung diseases like cancer or fibrosis, heart conditions, gastrointestinal issues, and other miscellaneous diseases. Doctors use objective criteria like nailbed measurements and positioning tests to assess and diagnose clubbing.

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    Fingers Clubbing –

    Also referred to as clubbed fingers, digital clubbing, drumstick appearance or parrot-beak


    appearance

    Changes of appearance due hyperthrophy of the connective tissue in the nail bed

    It is not harmful – can be a sign of disease

    Can affect fingers and/or toes and can be unilateral or bilateral

    Stages of clubbing:

    1 – increased fluctuancy of nail bed


    2 – loss of angle between nail and nail beds
    3 – increase curvature of nail
    4 – expansion of terminal phalanx ( drumstick / parrot beak)
    5 – HPOA

    Clubbing can be primary (idiopathic or hereditary) or secondary causes

    Primary causes:
    pachydermoperiostosis, familial clubbing, and hypertrophic osteoarthropathy

    Secondary causes:
    Pulmonary disease - Lung cancer, cystic fibrosis, interstitial lung disease,  idiopathic
    pulmonary fibrosis,  Sarcoidosis, empyema, Pulmonary TB

    Cardiac disease - Cyanotic congenital heart disease,  other causes of right-to-left


    shunting, and bacterial endocarditis

    Gastrointestinal disease - Ulcerative colitis, Crohn disease, primary biliary cirrhosis,


    cirrhosis of the liver

    Miscellaneous conditions - Acromegaly, thyroid acropachy, pregnancy, an unusual


    complication of severe secondary hyperparathyroidism,  sickle cell disease

    COPD does not cause clubbing !!!!!!!!!!!


    There are a few objective criteria that are used to assess clubbing, and they can help in
    determining whether you have developed this physical change:

     Lovibond's profile sign: Normally, there is a sharp angle between the nail bed and
    the cuticle. When you have clubbing, the natural angle is lost as the nail angles down
    instead of up.
     Distal/interphalangeal depth ratio: The phalanges of your finger are the sections
    between each bending joint. Your distal phalange, the one that includes your nail, is
    normally shorter depth-wise than the neighboring phalange. Clubbing is indicated
    when the opposite is true.
     Schamroth's sign: The sharp angle between your nail bed and cuticle forms a tiny
    diamond-shaped hole when you place your hands together with the top of your nails
    facing each other. When this gap disappears, it is described as Schamroth's sign

    Loss of diamond gap/shaped


    Pulse – tells us rate, rhythm, volume and characteristics (see CVS-pulse attached)

    Need to know:

    Pulse deficit - it is the difference between the heart rate and the pulse rate . It is commonly
    found in atrial fibrillation

    Radio radial delay - detect the radioradial delay you should simultaneously palpate both the
    radial arteries by both your hands, using  your left hand for  patients right radial artery and
    vice versa

    Following are the  causes of radio-radial delay 

     Normal anatomical variations.


     Thoracic inlet syndrome e.g. cervical rib. scalene syndrome.
     Aneurysm of  the aorta.
     Pre-subclavlan coarctation.
     Supravalvular aortic stenosis.
     Pulseless disease (Takayasu’s disease).
     Peripheral embolism.
     Atherosclerosis of aorta.
     Pressure over axillary artery by tumour, lymph nodes etc
    Radiofemoral delay and what are its causes - To detect the  radio-femoral delay, you
    should palpate the radial and femoral artery simultaneously. Normally there is no radio-
    femoral delay .

    Causes of radio-femoral delay are the following

     Coarctation ol aorta (It is an important bedside diagnostic clue in a young


    hypertensive).
     Atherosclerosis of aorta.
     Thrombosis or embolism of aorta.
     Aortoarteritis.

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