List 2 causes of clubbing (apart from cardiovascular and respiratory causes)
° Inflammatory bowel disease
There are numerous causes of clubbing.
Here is an unreasonably long list:
Causes of bilateral clubbing in both hands and feet
- Congenital heart disease, particularly cyanotic defects
- Congestive cardiac failure
- Aortic aneurysm
- Subacute bacterial endocarditis
- Arteriovenous fistula (and it would have to be a major one)
- Chronic lung disease of any sort, really;
- Bronchiectasis, which makes you think of cystic fibrosis
- COPD, asbestosis
- Pulmonary fibrosis of any aetiology
- Empyema which has been going on for a while
- Lung carcinoma (according T and O’C, usually not the small-cell variety)
- Cirrhosis; for some reason, particularly primary biliary cirrhosis
- Coeliac disease
- Inflammatory bowel disease
- Malignancy of the colon
Uncommon causes of clubbing
- Inherited familial (some people are just born that lucky – it’s a Mendelian dominant trait)
Causes of clubbing in feet only
- Coarctation of aorta
- Abdominal aortic aneurysm
Causes of unilateral clubbing
- Any sort of arterial aneurysm leading into the clubbed limb
- Apical lung tumour
Clinical Examination of the Critically Ill Patient, 3rd edition by L.I.G. Worthley - which can be ordered from our college here.
Clinical Examination: whatever edition, by Talley and O'Connor. Can be acquired any damn where. Get your own.
Rutherford, John D. "Digital Clubbing." Circulation 127.19 (2013): 1997-1999.
Velur, Prasuna, and Giridhar P. Kalamangalam. "Teaching NeuroImages: Unilateral clubbing in hemiplegia." Neurology 78.19 (2012): e122-e122.
Stoller, James K., et al. "Reduction of intrapulmonary shunt and resolution of digital clubbing associated with primary biliary cirrhosis after liver transplantation." Hepatology 11.1 (1990): 54-58.
Dickinson, C. J., and J. F. Martin. "Megakaryocytes and platelet clumps as the cause of finger clubbing." The Lancet 330.8573 (1987): 1434-1435.