Familial Clubbed Fingers

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

“…He reported that a profile sign of greater than 180 degrees could be used to differentiate true clubbing from other conditions such as simple nail curving and paronychia, which retained an angle closer to 160 degrees. Curth et al 44 found that the fingers of members of a family affected by familial clubbing were notable for a marked decrease in the angle between the back surface of the middle phalanx and that of the terminal phalanx, from 160 degrees in control subjects to 145 degrees in affected patients; they called this angle the ''modified profile angle.'' The authors note, however, that they prefer the use of Lovibond's original profile angle to detect more subtle clubbing.…”

Familial broad terminal phalanges with one individual showing additional anomalies

“…However, Richter and Hettmannsperger [1994] suggested that clubbing might depend on a genetic predisposition. Familial clubbing of the fingers and toes has been reported either as an isolated anomaly (MIM 119900) [Curth et al, 1961;Fischer et al, 1964;McKusick, 1994] or associated with hypertrophic osteoarthropathy (MIM 259100) [Currarino et al, 1961;McKusick, 1994]. The latter term refers to a well-known syndrome or sequence manifested principally by clubbing of fingers and toes, subperiostial proliferation in long bones, and arthropathy [Currarino et al, 1961], with roentgenographic findings in hands and feet resembling those seen in our patients (Figs.…”

“…7, 8). According to Curth et al [1961] ''simple'' clubbed fingers do not differ clinically or roentgenographically from those in familial hypertrophic osteoarthropathy (MIM 259100) and therefore, they might represent a form of hypertrophic osteoarthropathy. She concluded that this concept would be substantiated if in a single family some relatives had clubbed fingers alone and others clubbed fingers and hypertrophic osteoarthropathy, or, if in a single individual the disorder would progress from clubbed fingers toward hypertrophic osteoarthropathy [Curth et al, 1961].…”

“…According to Curth et al [1961] ''simple'' clubbed fingers do not differ clinically or roentgenographically from those in familial hypertrophic osteoarthropathy (MIM 259100) and therefore, they might represent a form of hypertrophic osteoarthropathy. She concluded that this concept would be substantiated if in a single family some relatives had clubbed fingers alone and others clubbed fingers and hypertrophic osteoarthropathy, or, if in a single individual the disorder would progress from clubbed fingers toward hypertrophic osteoarthropathy [Curth et al, 1961]. However, in the family we investigated, the digits did not show either the dorsal-palmar thickening and nail curvature nor the boggy fluctuation of the nail bed typical of clubbed fingers, there was no clinical evidence of arthropathy, and the long bones of the relatives with BTP and of the propositus were studied roentgenologically and found to be normal.…”

Clubbed fingers: Radiological evaluation of the nail bed thickness

“…The abnormality is characterized by an increase in the volume of the soft tissue in the nail beds of fingers with consequent obliteration of the angle formed between the nail and the dorsal aspect of the skin of the distal phalanx, as studied by Trousseau (1834) and Lovibond (1938). This clinical sign has been reported to occur in a variety of acquired diseases: in pulmonary diseases, as demonstrated by Dickinson (1992) and Sridhar et al (1998); in cardiac diseases, as demonstrated by Diop et al (1997) and Koegelenberg et al (2003); in extrathoracic diseases, as studied by Epstein et al (1979), Kitis et al (1979), and Fatourechi et al (2002); and in hereditary diseases, as demonstrated by Talbott and Montgomery Jr. (1953), Curth et al (1961) and Fischer et al (1964). Clubbing can appear as an isolated finding or can be part of the *Correspondence to: Klaus L. Irion, Department of Radiology, The Cardiothoracic Centre Liverpool NHS Trust, Thomas Drive, Liverpool, United Kingdom.…”