Clubbed Digits: An Enigma

Abstract

<h3>I. Introduction</h3> Clubbing is a frequently observed, often misdiagnosed, and inadequately explained phenomenon recognized since antiquity. Hippocrates^1,2first described it in empyema, noting that the "nails of the hands are bent, the fingers are hot especially their extremities."³Aretaeus associated clubbing with internal disease, and Aurelianus emphasized the increase in volume of the fingertips.⁴Pigeaux⁵published in 1832 the first definite work on the subject, and Marie wrote his classic article in 1890.⁶ Known by many different names, clubbing is most commonly referred to as pulmonary hypertrophic osteoarthropathy. <h3>II. Definition</h3> Clubbing is a clinical sign observed in the terminal phalanges which may or may not be associated with a pathological condition. If seen during disease, clubbing constitutes the early stage of a process of unknown pathogenesis and etiology in which the underlying condition causes changes in the soft tissues, in the periosteum, in the bone