New or Neglected Physical Signs in Diagnosis of Chest Diseases

Rabin, Coleman B.

doi:10.1001/jama.1965.03090180070017

Cited by 3 publications

(5 citation statements)

References 1 publication

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Section: Discussionmentioning

confidence: 72%

“…In the present study, the detection of finger clubbing was made by visual inspection performed by two experienced clinicians as already reported and also suggested [3,5,20,21]. According to the study protocol, findings compatible with clubbing, including abnormal nail-fold angles and abnormalities of the distal phalanges, were detected only by visual inspection and not by using not standardized devices [3,5,20,21]. This also in relation to the purpose of the study aimed to evaluate the frequency of finger clubbing in IBD patients, as detected during the routine clinical assessment.…”

Section: Discussionmentioning

confidence: 76%

“…Several not standardized modalities for assessing the presence of finger clubbing have been reported [3,5,20,21]. In the present study, the detection of finger clubbing was made by visual inspection performed by two experienced clinicians as already reported and also suggested [3,5,20,21]. According to the study protocol, findings compatible with clubbing, including abnormal nail-fold angles and abnormalities of the distal phalanges, were detected only by visual inspection and not by using not standardized devices [3,5,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…Despite several attempts, no standard diagnostic criterion is currently available to identify and quantitate finger clubbing [3]. No gold standard indeed exists for detecting clubbing, although several devices have been proposed [3,15,20,21]. Inspection of the fingers for compatible signs, performed by a skilled physician, is therefore considered appropriate to search for clubbing [3,15,21].…”

Section: Methodsmentioning

confidence: 99%

“…No gold standard indeed exists for detecting clubbing, although several devices have been proposed [3,15,20,21]. Inspection of the fingers for compatible signs, performed by a skilled physician, is therefore considered appropriate to search for clubbing [3,15,21]. Due to these observations, in the present study, the presence of this sign was based on visual inspection of the profile fingers’ shape, aimed to search for abnormal nail-fold angles and for changes of the morphology of the distal phalanges (drumstick-like fingers) [3,15,20,21].…”

Section: Methodsmentioning

confidence: 99%

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Finger clubbing in inflammatory bowel disease: association with upper small bowel lesions and need of surgery in Crohn’s disease

Romeo

Neri

Mossa

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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Objective Finger clubbing has been associated with inflammatory bowel disease (IBD). Aims In a prospective single-center study, we aimed to assess the frequency of finger clubbing in a cohort of IBD patients. Whether finger clubbing is associated with clinical characteristics of IBD was also investigated. Methods IBD patients with a detailed clinical history were enrolled. Finger clubbing was assessed by visual inspection. Data were expressed as median (range), chi-square, t-test. Multivariate logistic regression analysis was used to assess risk factors for finger clubbing, when considering demographic and clinical characteristics, smoking habits and chronic pulmonary diseases (CPD). Results Finger clubbing was searched in 470 IBD patients: 267 Crohn’s disease and 203 ulcerative colitis. Finger clubbing was more frequent in Crohn’s disease than in ulcerative colitis: 45/267 (16.8%) vs. 15/203 (7.3%) [odds ratio (OR), 2.54 (1.37–4.70); P = 0.003]. Crohn’s disease involved the ileum (59.9%), colon (4.5%), ileum-colon (25.8%) and upper gastrointestinal (GI) (9.8%). Ulcerative colitis extent included proctitis (E1) (13.4%), left-sided (E2) (43.3%) and pancolitis (E3) (43.3%). Upper GI lesions, but not other Crohn’s disease localizations, were more frequent in patients with finger clubbing [9/45 (20%) vs. 17/222 (7.7%); P = 0.032]. Crohn’s disease-related surgery was more frequent in patients with finger clubbing [36/45 (80%) vs. 107/222 (48.1%); P < 0.001]. In Crohn’s disease, the only risk factors for finger clubbing were upper GI lesions and Crohn’s disease-related surgery [OR, 2.58 (1.03–6.46), P = 0.04; OR, 4.07 (1.86–8.91), P = 0.006]. Ulcerative colitis extent was not associated with finger clubbing [E1: OR, 0.27 (0.02–3.44), P = 0.33; E2: OR, 0.93 (0.24–3.60), P = 0.92; E3:OR, 0.64 (0.22–1.86), P = 0.59]. In ulcerative colitis, but not in Crohn’s disease, finger clubbing was more frequent in smokers [13/15 (86.6%) vs. 99/188 (52.6%); P = 0.01] and in patients with CPD [5/15 (33.3%) vs. 16/188 (8.5%); P = 0.002]. Smoking and CPD were the only risk factors for finger clubbing in ulcerative colitis [OR, 7.18 (1.44–35.78), P = 0.01; OR, 10.93 (2.51–47.45), P = 0.001]. Conclusion In the tested IBD population, finger clubbing was more frequent in Crohn’s disease than in ulcerative colitis. In Crohn’s disease, upper GI lesions and history of Crohn’s disease-related surgery were risk factors for finger clubbing, suggesting the possible role of finger clubbing as a subclinical marker of Crohn’s disease severity.

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