Clubbing of the fingers or toes

• congenital heart disease (cyanotic type)
  • tetralogy of Fallot
  • tricuspid atresia
  • transposition of the great vessels
  • total anomalous venous return
  • truncus arteriosus

• atrial myxoma; left
• atrial myxoma; right
• cystic fibrosis
• emphysema
• tuberculosis
• bronchiectasis
• Crohn's disease
• celiac disease
• chronic active hepatitis
• cirrhosis
• lymphoma , Hodgkin's disease

Note: There may be other causes of clubbing. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for clubbing, occurring alone or in combination with other problems.

Home Care:
There is no specific treatment for the clubbing itself. Home care depends on the specific diagnosis.

Call Your Healthcare Provider If:

• you notice clubbing. However, this is a relatively late symptom, and other earlier symptoms have usually occurred that require the attention of your health care provider.

What to Expect:
A person with clubbing generally has other symptoms and signs (usually heart and lung disease ) that, when taken together, define a specific syndrome or condition. Diagnosis of that condition is based on the family history, medical history, and thorough physical evaluation.

Medical history questions documenting clubbing in detail may include:

• time pattern
  • When did you first notice this?

• location
  • Does it affect the fingers, toes, or both?

• quality
  • Has it been becoming more noticeable?

• other
  • What other symptoms are also present?
  • Is there any breathing difficulty ?
  • Is the skin ever bluish colored?

The physical examination may include thorough assessment of the chest and breathing.

Diagnostic tests that may be performed are:

• arterial blood gas
• pulmonary function tests
• chest X-ray
• echocardiogram
• EKG

After seeing your health care provider:
You may want to add a diagnosis related to clubbing to your personal medical record.


Clubbing results from chronic low blood-oxygen levels. This can be seen with cystic fibrosis, congenital cyanotic heart disease, and several other diseases. The tips of the fingers enlarge and the nails become extremely curved from front to back.