Images in Clinical Medicine

Idiopathic Clubbing

Klaus Reynen, M.D., and Werner G. Daniel, M.D.

N Engl J Med 2000; 343:1235October 26, 2000

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Figure 1 A 44-year-old man had had marked swelling of the terminal digits since early childhood. No other family members had this finding. The patient did not have cyanosis, was not limited in terms of physical activity, and had no history of cardiac disease, lung disease, or inflammatory bowel disease. On examination, cardiac and pulmonary findings were normal, as were the results of lung-function tests and laboratory tests, including measurements of liver-enzyme and bilirubin levels. Electrocardiography and radiography of the chest revealed no abnormalities. On bicycle ergometry, the patient reached a workload of 175 W. Right heart catheterization, including oximetry, showed normal pulmonary-artery pressures and excluded the possibility of intracardiac shunting.

Klaus Reynen, M.D.
Werner G. Daniel, M.D.
University of Dresden, 01307 Dresden, Germany

Citing Articles (4)

Citing Articles

1. 1

   X. Vandemergel, B. Renneboog. (2008) Prevalence, aetiologies and significance of clubbing in a department of general internal medicine. European Journal of Internal Medicine 19:5, 325-329
   CrossRef

2. 2

   Shinichi KOBA, Noriyuki MISAGO, Yutaka NARISAWA. (2007) Knuckle pads associated with clubbed fingers. The Journal of Dermatology 34:12, 838-840
   CrossRef

3. 3

   Kerith E. Spicknall, Matthew J. Zirwas, Joseph C. English. (2005) Clubbing: An update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance. Journal of the American Academy of Dermatology 52:6, 1020-1028
   CrossRef

4. 4

   (2001) Idiopathic Clubbing. New England Journal of Medicine 344:8, 611-611
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