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Have you heard about finger clubbing?

Clubbing of the finger can point to an underlying health conditions.

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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.

Clubbed fingers by themselves are not harmful, but since it can be a sign of lung cancer, among other diseases, it is important that your medical team identifies the cause and that you are treated for your underlying condition.

This article covers causes and symptoms of clubbed fingers and clubbed nails, along with how clubbed fingers are diagnosed and treated.

Primary vs Secondary Clubbing

Clubbed fingers, nails, or toes are typically a sign of severe disease, but not always.

Primary (idiopathic) clubbing is clubbing that occurs alone, without the presence of any underlying disease. Primary clubbed fingers, toes, and nails are a rare inherited trait—accounting for just 3% of all clubbing cases.

Secondary clubbing occurs as an effect of another health problem, such as lung cancer, heart disease, or cirrhosis of the liver. In fact, secondary clubbing is caused by lung cancer or lymphoma in approximately 80% of cases.

Symptoms

Clubbing can involve your fingers and/or toes. It is typically bilateral (affecting both hands and/or feet) and it should be equal in terms of its extent on both sides.

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 primary HOA, other family members are also likely to have clubbed fingers and/or clubbed toe.

Secondary clubbing happens gradually, and it causes a change in the appearance of your fingers and/or toes. With secondary clubbing, which is caused by disease, you would also have other features that are not seen in primary clubbing.

Features of secondary clubbed nails include:

  • Softening of the nails
  • Nail beds that soften and feel spongy
  • Nails that seem to “float” instead of being firmly attached to your fingers
  • Disappearing of the angle between your nails and cuticle
  • Enlargement or bulging of the distal portion of your finger (where your finger meets your nail)
  • Warm, red nail beds
  • Nails that curve downward and look like the bottom of the round part of a spoon

Eventually, the nail and skin around the nail may become shiny, and the nail develops ridging..Do you know that you can get a Perfect Manicure at Home?

Causes

Primary clubbing is hereditary, and it is passed down via genes. Hereditary one is simply a physical feature, like the color of your eyes or your height. Several genes have been associated with primary clubbing, including the HPGD gene.

effects of chronic lung and heart disease. Lung cancer is the most common cause of clubbed nails. This sign is also associated with a number of other chronic illnesses, including conditions that involve the thyroid gland or the digestive system.


There are a number of health risk factors associated with secondary clubbing, including:

  • Lung cancer
  • Interstitial pulmonary fibrosis
  • Lung abscess
  • Pulmonary tuberculosis
  • Pulmonary lymphoma
  • Congestive heart failure
  • Infective endocarditis

Treatment

Usually, the abnormal shape and size of the digits do not cause health problems, but any underlying disease that causes clubbing needs to be medically and/or surgically managed, as appropriate. Treatments may prevent your clubbed nails from worsening and, in rare cases, can reverse some or all of the physical features of clubbing.

There are a variety of approaches used to treat the underlying cause of clubbed nails. Your treatment will depend on your situation. You may need management of respiratory disease, treatment of heart disease, or interventional therapy for cancer.

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