Clubbed Fingers Or Toes

Alternative names: Clubbing, Nail Clubbing, Clubbed Nails, Clubbing of the Fingers, Clubbing of the Toes, Digital Clubbing.

Clubbed fingers (or, more rarely, clubbed toes) are not a disease in themselves, but often a symptom of disease.

Although nail clubbing is not always diagnostically significant, it is often an indicator of serious underlying disease.

Incidence; Causes and Development

Digital clubbing appears to be present in roughly 1% of the population, though precise figures are unavailable.

The main causes of clubbed fingers are generally conditions involving the heart and/or lungs that cause chronically low blood levels of oxygen, and conditions that cause malabsorption.  These include:

• Lung Cancer
• Cystic Fibrosis
• Interstitial Lung Disease, usually Fibrosing Alveolitis
• Tuberculosis
• Lung Abscess
• Lung Empyema
• Bronchiectasis
• Asbestosis
• Mesothelioma
• Arteriovenous Fistula
• Arteriovenous Malformation
• Vasculitis
• Congenital Cyanotic Heart Disease
• Bacterial Endocarditis
• Atrial Myxoma (benign heart tumor)
• Carbon Monoxide Poisoning
• Pregnancy
• Altitude Sickness
• Cyanide Poisoning
• Intestinal Malabsorption
• Cystic Fibrosis
• Biliary Cirrhosis
• Hepatopulmonary Syndrome
• Leiomyoma of the Esophagus
• Peptic Ulceration of the Esophagus
• Achalasia
• Graves' Disease
• Thyroid Acropachy
• Hyperparathyroidism
• Acromegaly
• Thyroid Cancer
• Thymus Cancer
• Hodgkin Disease
• Disseminated Chronic Myeloid Leukemia (CML)
• Sickle Cell Disease
• Hypoxemia
• Kidney Failure

Clubbed fingers or toes usually develop over a period of weeks to years, depending on the underlying cause.  Asthma does not lead to clubbed fingers.

Signs and Symptoms

Clubbing is a widening of the ends of the fingers (or toes) after the last (distal) joint.  The affected nails are widened and usually exhibit increased curvature.

Clubbing usually affects all fingers or toes of a hand or foot, but may only affect one or a few digits.  Onset is often very gradual, and patients are often unaware of it.  It is usually painless.

Diagnosis and Tests

Clubbing is easily diagnosed: it is a clinical finding characterized by tapered, bulbous enlargement of the distal portion (end) of a finger or toe.  The nail moves more freely, with a 'spongy' feeling when it is pressed down.

Treatment and Prevention

Clubbing may resolve on its own once the underlying disease condition has been remedied.

Seek medical attention if...

Most of the underlying conditions that cause clubbing are serious, and seeing a doctor for early diagnosis and treatment may improve your chances.