Clubbing

Clubbing of the digits is a cardinal sign of pulmonary disease. It is the finding of increased vascular connective tissue in the distal segments of the digits, which results in the characteristic enlargement of the tips of the digits and exaggerated curvature. Clubbing may occur in isolation, or it may be part of a syndrome called hypertrophic osteoarthropathy, in which periostosis (deposition of new bone) of long bones and joint pains also occur.

Pulmonology Tutorial

Patient 1

This is a middle-aged woman with cirrhosis who was found to have digital clubbing, likely caused by hepatopulmonary syndrome. Also note the palmar erythema.