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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is clubbing of the fingers indicated in the attached photos?

Answered by
Dr.
Dr. Jnikolla

Pulmonologist

Practicing since :2003

Answered : 1352 Questions

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Posted on Sat, 2 Jun 2018 in Lung and Chest disorders
Question: Hey doc i asked you a question about finger clubbing about a week ago. i wanted to send you some more pictures and get your thoughts. i read online about a phalangeal depth ratio where the distal part of the nail (from cuticle down) should be smaller than the middle joint and if you divide the two the ratio is less than 1. I put lines on a few photos i took of my fingers. it seems like the ends of my fingers are bigger or the same size as the middle. is this clubbing?
doctor
Answered by Dr. Jnikolla 1 hour later
Brief Answer:
No it is not clubbing

Detailed Answer:
Hello and welcome in HCM

Its doctor Jolanda pulmonologist answering to you

I can understand your concern

I have evaluated carefully your attached images of your fingers.

According to that images i do not think that you have finger clubbing signs fortunately.

In clubbing fingers the XXXXXXX between the cuticle and the distal part of the second phalanges should be < 165 degree

Because clubbing usually is a sign of several diseases conditions such as lung or heart problems.However in 30% of cases we can not find any diseases associated and these are called *hereditary clubbing*

I was wondering why are you asking about clubbing?
Do you have any symptom like chronic cough or does your relative have clubbing?

Please give me some more info in order i can help you more regarding.

Regards and feel free to ask me again

Dr.Jolanda


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Jnikolla 6 minutes later
i have crohns disease which i read that clubbing of the fingers can be associated with. never knew it was possible but i guess i
roughly 30% or so of crohns patie ts have some degree of nail clubbing. i checked my nails and all my nails have a schamroth sign but the tips seem a bit fatter on my middle and ring finger. was just curious what consritutes clubbing and is clubbing possible with a normal nail angle?
doctor
Answered by Dr. Jnikolla 15 minutes later
Brief Answer:
continue discussion

Detailed Answer:
Hi again

Clubbing is defined as a physical sign characterized by bulbous enlargement of the ends of one or more fingers or toes. This cause the proliferation and the edema of connective tissue which results in loss of the normal angle between the skin and nail plate and excessive sponginess of the nail base.

Probably you might have a pseudo clubbing or a very early finger clubbing.

There are several tests to distinguish them from each other.

Nevertheless you can discuss with your treating doctor for the above and he can examine better your fingers because it is hard from the images.

Hope to have been helpful

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Jnikolla 7 minutes later
the pictures though that I showed you do not show any clubbing though correct?
doctor
Answered by Dr. Jnikolla 6 minutes later
Brief Answer:
continue discussion

Detailed Answer:
Hi


Yes exactly, from the pictures i do not see any sign of finger clubbing. No worries

Regards


Dr.Jolanda

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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