Clubbed Fingernails Or Toenails

What Causes Nail Clubbing?

Nail clubbing can have various causes, ranging in severity from 'very minor' to 'generally fatal'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose nail clubbing, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "nail clubbing" as a symptom.  Here are seven possibilities:
  • Cirrhosis Of The Liver
  • Hepatitis
  • Gluten Sensitivity
  • Ulcerative Colitis
  • Crohn's Disease
  • Pulmonary Fibrosis
  • Sarcoidosis

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
frequent confusion/disorientation
frequent meal-related bloating
nails that are mostly white
elevated ESR
severe abdominal pain
cigarette smoke sensitivity
constant fatigue
history of occult blood
offensive-smelling stool
much reduced sense of smell
unexplained fevers that hit hard
red palms/fingertips
... and more than 110 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of nail clubbing:
Cause Probability Status
Hepatitis 93% Confirm
Crohn's Disease 28% Unlikely
Sarcoidosis 22% Unlikely
Gluten Sensitivity 0% Ruled out
Ulcerative Colitis 0% Ruled out
Pulmonary Fibrosis 0% Ruled out
Cirrhosis Of The Liver 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate abnormal fingernails and toenails, The Analyst™ will ask further questions including this one:
Are your fingers or toes 'clubbed', being wider and bulging at the ends? Clubbed fingers or toes have nails that are wider and more rounded than normal, often curving downwards.
Possible responses:
→ No, my fingers are normal width / don't know
→ Yes, slightly
→ Yes, there is very noticeable clubbing
Based on your response to this question, which may indicate either minor digital clubbing or significant digital clubbing, The Analyst™ will consider possibilities such as:
Hepatitis

Chronic hepatitis C can cause nail clubbing.

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