Clubbing why

List of Partners vendors. Clubbing of the fingers, also described as hypertrophic osteoarthropathy HOA , is an enlargement of the ends of the fingers accompanied by a downward sloping of the nails. You can have primary HOA, which is simply a clubbed appearance of your fingers that is not associated with any health problems.

Or you can develop secondary clubbing, which is caused by health problems such as lung cancer and heart disease. The clubbing itself is not harmful, but since it can be a sign of disease, it is important that your medical team identifies the cause and that you are treated for your underlying condition. Clubbing is also referred to as clubbed fingers, digital clubbing, watch-glass nails, drumstick fingers, Hippocratic fingers, Hippocratic nails.

If you or your child has primary HOA , then your fingers or toes may naturally appear large, bulging, and rounded. This will be noticeable during childhood or during the teenage years, and it will not change much over time. With secondary clubbing, which is caused by disease, you would also have other features that are not seen in primary clubbing.

Features of secondary clubbing include:. Eventually, the nail and skin around the nail may become shiny, and the nail develops ridging. Primary clubbing is hereditary, and it is passed down via genes. Hereditary clubbing is simply a physical feature, like the color of your eyes or your height. Secondary clubbing occurs as one of the effects of chronic lung and heart disease. Lung cancer is the most common cause of clubbing.

This sign is also associated with a number of other chronic illnesses, including conditions that involve the thyroid gland or the digestive system. The medical conditions that can cause clubbing are generally associated with decreased oxygen levels. Experts suggest that clubbing occurs as your body undergoes changes in response to low oxygen. Several processes affect the nail beds in secondary clubbing. The nail enlargement occurs due to the growth of excess soft tissue beneath the nail beds.

The enlargement is associated with inflammation and a proliferation of small blood vessels in the nail beds. A protein called vascular endothelial growth factor stimulates the growth of blood vessels, and this protein is considered a major factor in the physical changes that occur in clubbing.

Clubbing can be subtle, so it may be difficult for you and your medical team to verify this change in your digits. 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:.

Often, clubbing develops due to a chronic medical condition that was diagnosed years before the clubbing developed. When you start to have clubbing of your digits, your medical team will evaluate you to identify any underlying disease that could be causing it. This can be seen with cystic fibrosis, congenital cyanotic heart disease, and several other diseases.

The tips of the fingers enlarge and the nails become extremely curved from front to back. Clubbed fingers is a symptom of disease, often of the heart or lungs which cause chronically low blood levels of oxygen. Diseases which cause malabsorption, such as cystic fibrosis or celiac disease can also cause clubbing. Clubbing can develop quickly, often within weeks. It also can go away quickly when its cause is treated.

Lung cancer is the most common cause of clubbing. Clubbing often occurs in heart and lung diseases that reduce the amount of oxygen in the blood. These may include:. A person with clubbing often has symptoms of another condition. Diagnosing that condition is based on:.

General patient examination and differential diagnosis. Hutchison's Clinical Methods. Philadelphia, PA: Elsevier; chap 2. Fajardo E, Davis JL. If you develop clubbing of your fingers or toes, make an appointment with your doctor.

This activation plays a role in changing the nail bed. Nail widening that characterizes clubbing happens when the tissue under your nail plate becomes thicker. This can be triggered by a number of conditions throughout the body. For example, clubbing often results from lung issues, such as:. To treat clubbing, your doctor will need to address the underlying cause of your symptoms. Your recommended treatment plan will depend on your diagnosis.

For example, your doctor may prescribe:. In rare cases, your doctor may recommend a lung transplant to treat serious lung disease.

The only way to prevent clubbing is by taking steps to prevent and manage the underlying conditions that cause it. For example, you can:. Most of the underlying conditions that cause clubbing are serious. Early diagnosis and treatment may improve your outlook. Talk with your doctor if you notice any signs of clubbing of your toes or fingers. Typically, treatment and management of clubbing is focused on treating the underlying condition. The more serious or farther along the underlying condition, the harder it may be to reverse clubbing of the fingers.