Nail Clubbing Causes and Mnemonic “CLUBBING“
Clubbing is a selective bulbous enlargement of the distal portion of the digit due to increased subungual soft tissue.
Causes of Nail Clubbing:
Congenital/ familial causes:
Congenital hypertrophic pulmonary osteoarthropathy
Pulmonary disorders:
Long-standing pulmonary tuberculosis
Suppuration of lung
- Bronchiectasis
- Lung abscess
- Cystic fibrosis
- Empyema
Tumors of lung
- Mesothelioma
- Primary lung cancer
- Metastatic lung cancer
Cardiovascular causes:
- Cyanotic congenital heart disease
- Bacterial endocarditis
- Atrial myxoma
- Eisenmenger’s syndrome
Gastrointestinal (GI) causes:
- Cirrhosis of liver
- Ulcerative colitis
- Crohn’s disease
- GI malignancy
Miscellaneous:
- Syphilis
- Syringomyelia
- Acromegaly
- Thyrotoxicosis
- Unilateral: Pancoast tumor, subclavian and innominate artery aneurysm
- Unidigital: Traumatic or tophi deposit in gout
Nail clubbing mnemonic: “CLUBBING”
C = Cyanotic heart disease, Cystic fibrosis
L = Lung cancer, Lung abscess
U = Ulcerative colitis
B = Bronchiectasis
B = Benign mesothelioma
I = Infective endocarditis, Idiopathic pulmonary fibrosis
N = Neurogenic tumors
G = Gastrointestinal diseases
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