A site for medical students - Practical,Theory,Osce Notes

What are the causes of clubbing?

Cardiovascular cause of clubbing 
  • Infective endocarditis
  • Cyanotic CHD
  • Myxoma of atria
  • Aneurism of major vessels such as aorta and  subclavian artery
Gastrointestinal causes of clubbing 
  • Malabsorption
  • IBD - Crohn's, ulcerative colitis
  • Cirrhosis of liver particularly biliary cirrhosis
Respiratory causes of clubbing
  • Broochiectasis.
  • Lung abscess.
  • Bronchogenic carcinoma.
  • Empyma thoracis.
  • Fibrosing alveolitis.
  • Pleural mesothelioma.
  • Pulmonary arteriovenous fistula.
  • Cystic fibrosis.
In pulmonary tuberculosis clubbing denotes
  • Post tuberculous bronchiectasis
  • Diffuse B/L lung fibrosis
  • Empyema
Others  causes of clubbing 
  • Congenital 
  • Thyrotoxicosis 
  • Acromegaly
  • Unidigital clubbing is seen in - sarcoidosis, trauma, gout.
  • Pachydermoperiostosis
  • Thyroid acropachy
What are the different types of clubbing?
Drum stick type of clubbing  is seen in
  • Congenital cyanotic heart diseases, e.g. Fallot's tetralogy.
  • Bronchiectasis.
Parrot-beak type of clubbing : Commonly seen in bronchogenic carcinoma.
What are the  causes of painful clubbing ?
  • Bronchogenic carcinoma.
  • SBE.
What are the causes of unilateral clubbing ?
  • Presubclavian coarctation of aorta (left sided clubbing).
  • Bronchogenic carcinoma.
  • Cervical rib.
  • Aneurysm of subclavian artery.
  • Ervthromelalgia.
  • Arteriovenous fistula of brachial vessels.
What are the causes of unidigital clubbing?
  • Hereditary (if bilateral).
  • Local trauma.
  • Rarely from median nerve injury' or deposition of tophi (gout).
  • Sarcoidosis.
Causes of clubbing limited to upper extremity ?
Chronic obstructive phlebitis of upper extremity as a result of chronic I.V drug addiction (eg. heroin).
Causes of clubbing limited to lower extremity ?
In infected abdominal aortic aneurysm : sometimes in PDA with reversal of shunt.
What is the cause of acute clubbing ?
Development of clubbing within 10 to 14 days of onset of illness.This is seen in lung abcess
What are the causes of pseudoclubbing?
Psuedoclubbing is seen in conditions associated with subperiosteal bone resorption of terminal phalanges. Here there is absence of soft tissue proliferation and increased curvature of nails and is seen in.
  • Scleroderma.
  • Acromegaly.
  • Hyperparathyroidism.
  • Leprosy.