Clubbing: An update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance

Spicknall, Kerith E.; Zirwas, Matthew J.; English, Joseph C.

doi:10.1016/j.jaad.2005.01.006

Cited by 134 publications

(112 citation statements)

References 64 publications

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“…Nor were there any differences related to preoperative symptoms, tumor histology, clinical staging, or site of the pulmonary lesion. The use of tested objective measurement criteria (1,16) certainly is an advantage over the subjective clinical impression, with its inherent difficulties for comparisons of the late postoperative appearance of the fingers with their preoperative aspect. The method employed for the production and registration of images of the fingers, (21) exploring the shadow projection, similar to others previously reported, (18) is also very simple and easy to perform.…”

Section: Discussionmentioning

confidence: 99%

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Regressão do hipocratismo digital em pacientes com câncer de pulmão tratados cirurgicamente

et al. 2008

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Objective: To objectively evaluate the reversal of digital clubbing (DC) in a series of surgically treated lung cancer patients, and to review the literature on the subject. Methods: Sixty-one patients with non-small cell lung cancer-40 with and 21 without DC-were treated by pulmonary resection. Eleven (18%) received additional postoperative radiation therapy. Preoperatively, as well as on postoperative days 7, 18, and 90, the hyponychial angle (HA) and the distal phalangeal depth/interphalangeal depth (DPD/IPD) ratio were determined on profile shadow projections of the index fingers. A review of the literature on reversal of DC (1954DC ( -2007 was also performed. Results: From the preoperative period to postoperative day 90, HA decreased from 200.5 ± 5.0° to 193.3 ± 6.8° (p < 0.001), and the DPD/IPD ratio decreased from 1.014 ± 0.051 mm to 0.956 ± 0.045 mm (p < 0.001) in the group of 40 patients with DC. The HA and the DPD/IPD ratio decreased in 33 (82.5%) but remained the same in 7 (1.7%), 6 with unfavorable evolution. In the 21 patients without DC, HA (184.5 ± 5.5°) and the DPD/IPD ratio (0.937 ± 0.046 mm) remained unchanged after surgery. In the literature , we found 52 cases, 5 of which were lung cancer cases, in which reversal of DC, observed in several clinical conditions, was explicitly reported. Conclusion: In most lung cancer patients, DC resolves after effective surgical treatment of the tumor, as can occur in patients with other conditions. Keywords: Osteoarthropathy, secondary hypertrophic; Lung neoplasms; Pulmonary surgical procedures. ResumoObjetivo: Estudar, por meio de avaliações objetivas, a ocorrência de regressão do hipocratismo digital (HD) em pacientes com câncer de pulmão, tratados cirurgicamente, e revisar a literatura sobre o assunto. Métodos: Sessenta e um pacientes com câncer de pulmão não-pequenas células-40 com e 21 sem HD-foram tratados por cirurgia de ressecção pulmonar. Onze deles (18%) também receberam radioterapia pós-operatória. No período pré-operatório e no 7º, no 18º e no 90º dia pós-operatório, o ângulo hiponiquial (AH) e a relação entre as espessuras falangeana distal e interfalangeana (EFD/EIF) foram determinados sobre imagens da sombra dos dedos indicadores em perfil. Uma revisão da literatura sobre regressão do HD (1954HD ( -2007 também foi efetuada. Resultados: Do período pré-operatório ao 90º dia pós-operatório, o AH diminuiu de 200,5 ± 5,0° para 193,3 ± 6,8° (p < 0,001), e a relação EFD/EIF, de 1,014 ± 0,051 mm para 0,956 ± 0,045 mm (p < 0,001) no grupo de 40 pacientes com HD. Em 33 (82,5%), o AH e a relação EFD/EIF diminuíram, mas, em 7 (1,7%), 6 com evolução desfavorável, esses valores não se reduziram. Nos 21 pacientes sem HD, tanto o AH (184,5 ± 5,5°) como a relação EFD/EIF (0,937 ± 0,046 mm) permaneceram inalterados após a cirurgia. Na literatura foram encontrados 52 casos em que a regressão do HD, observada em diversas condições clínicas, foi explicitamente referida, 5 dos quais eram casos de câncer de pulmão. Conclusões: O HD em pacientes com câncer d...

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Section: Discussionmentioning

confidence: 99%

“…Digital clubbing (DC) is a clinical sign that is of diagnostic value, (1) typically indicating pulmonary (2) or cardiac (3) disease. It can also be related to chronic liver diseases, (4) bowel diseases, (5) and thyroid diseases, (6) or it can be hereditary.…”

Section: Introductionmentioning

confidence: 99%

Regressão do hipocratismo digital em pacientes com câncer de pulmão tratados cirurgicamente

et al. 2008

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“…Causes of cyanosis include intracardiac right-left shunts, lung diseases and pulmonary arteriovenous malformation (AVM). Clubbing is due to fibrovascular proliferation in nail beds, mediated by platelet derived growth factor released from megakaryocytes or platelet emboli which do not reach nail bed unless there is pulmonary capillary damage or intracardiac shunts [1]. Here we discuss a rare cause of dyspnea, cyanosis and clubbing associated with cirrhosis which mimicked primary cardiopulmonary disease.…”

Section: Introductionmentioning

confidence: 96%

Liver disease masquerading as primary cardiopulmonary disease: Hepatopulmonary syndrome as a result of idiopathic cirrhosis

Aravinda¹,

Ratnatilaka²,

Sadikeen³

2017

IJCRI

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“…CD4+ lymphocyte count was 401/μL and viral load was 205,000 copies/mL. 1 Digital clubbing is associated with HIV. Among one convenience sample of 76 HIV-infected patients, 28 (36 %) had objectively confirmed clubbing-thus, HIV testing is recommended as part of a diagnostic algorithm.…”

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confidence: 95%

Clinical Image: Clubbed with a Reminder to Test for HIV

Siddiqui

Melia

2014

J GEN INTERN MED

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Clubbing: An update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance

Cited by 134 publications

References 64 publications

Regressão do hipocratismo digital em pacientes com câncer de pulmão tratados cirurgicamente

Regressão do hipocratismo digital em pacientes com câncer de pulmão tratados cirurgicamente

Liver disease masquerading as primary cardiopulmonary disease: Hepatopulmonary syndrome as a result of idiopathic cirrhosis

Clinical Image: Clubbed with a Reminder to Test for HIV

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