Select personalised content. Create a personalised content profile. Measure ad performance. Select basic ads. Create a personalised ads profile. Select personalised ads. Apply market research to generate audience insights. Measure content performance. Develop and improve products. 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. Read on to learn more about what clubbed fingers are, their symptoms, common causes, diagnosis, and treatment.
Some medical conditions can cause the soft tissues at the ends of the fingers to become inflamed, which can change the shape of the finger and nail. This is called clubbing. These changes gradually straighten the natural dip where the finger meets the nail bed and create a noticeable convex dip and hyperextension at the end finger joint. In later stages, the nails may become especially shiny or glossy, and long vertical marks may appear on the surrounding skin.
The inflammation at the fingertips tends to make them feel warm and appear enlarged and red. Clubbing can also cause the nail beds to look and feel like they are floating on a cushion. The nail beds become loosely attached as the root of the nail plate is pushed away from the bone. The nail bed may move when someone applies pressure to it. Clubbing tends to affect the thumb and forefinger first before progressing to the other fingers.
Symptoms of clubbed fingers typically impact both hands. The condition is painless. A range of underlying conditions can cause clubbing, usually those that interfere with oxygen exchange. That can cause low oxygen levels in the blood and tissues, known as hypoxia. Hypoxia stimulates an increase in the density of small blood vessels called capillaries.
It does this by increasing the release of platelet-derived growth factor PDGF and vascular endothelial growth factor VEGF by special cells called peripheral megakaryocytes. Several other signaling proteins are also associated with clubbed fingers, though scientists need to do more research to determine specifically how they contribute to disease development. Causes fall into one of four categories: infectious conditions, inflammatory conditions, neoplasms abnormal growths , and vascular disease.
In some cases clubbing can also be a benign, hereditary condition that develops due to genetic mutations. Some of the most common conditions known to cause clubbing include the following:. Conditions that reduce lung function can reduce circulating oxygen levels and trigger clubbing. Lung diseases, especially cancer, are the most common cause of clubbing. Signs of lung disease include :. Conditions that interfere with the blood circulation can also reduce circulating oxygen levels and trigger clubbing, especially in the extremities.
Symptoms associated with cardiovascular causes of clubbing include :. Many people do not know they have liver disease until it has progressed to later stages. 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.
While there is not much research around the total reversal of clubbing, it has been reported in individuals undergoing prostaglandin therapy for liver disease. Clubbing was reversed by the time their therapy was over.
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