Clubbing (Hippocratic fingers)

CLINICAL DIAGNOSIS MANUAL

"Clubbing," also known as digital clubbing or drumstick fingers, is a deformity of the nails and fingertips that occurs due to chronic changes in connective tissue.

It is important in a medical context because it can be a sign of various diseases, particularly those affecting the lungs and heart. Here is a description of the clinical features and complementary tests in the table below:

Pathology	Suspected Diagnosis	Confirmatory Diagnosis
Subacute bacterial endocarditis	Fever, heart murmur, non-specific symptoms	Positive blood cultures, echocardiogram showing vegetative lesions
Cyanotic congenital heart disease	Cyanosis, dyspnoea, heart murmur	Echocardiogram showing structural heart defects
Bronchial carcinoma	Chronic cough, weight loss, haemoptysis	Lung biopsy confirming malignancy
Bronchiectasis	Chronic cough with sputum production, recurrent infections	High-resolution chest CT scan
Lung abscess	Fever, cough, purulent sputum production	Chest CT scan, positive sputum culture
Empyema	Chest pain, fever, dyspnoea	Pleural drainage with positive pleural fluid analysis
Fibrosing alveolitis	Progressive dyspnoea, dry cough	Lung biopsy or pulmonary function tests showing restrictive patterns
Cirrhosis	Fatigue, jaundice, ascites	Abdominal ultrasound, liver biopsy
Crohn's disease	Abdominal pain, diarrhoea, weight loss	Colonoscopy with biopsy showing granulomatous inflammation
Ulcerative colitis	Abdominal pain, rectal bleeding, diarrhoea	Colonoscopy with biopsy showing continuous inflammation and ulcers