Clubbing of the Nails Clinical Presentation

Updated: Mar 15, 2023
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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The development of clubbing usually is gradual enough that many patients are unaware of its presence; however, some patients may report swelling of the distal portion of the digits, which may be bilateral or unilateral or may involve a single digit. Unilateral clubbing can be seen in hemiplegia. [45]

Although clubbing typically is painless, it rarely may present with pain in the fingertips.

Rapid postoperative resolution of clubbing in a few days was described in a patient with aortic and mitral valve replacement due to infective endocarditis. [46]

Hypertrophic osteoarthropathy may occur as an isolated calcaneal periostitis bilaterally. [47]

Finger clubbing may be a clue to an underlying systemic disorder, including vasculitis with chronic hepatitis C and type II mixed cryoglobulinemia. [48]



Since clubbing is a clinical finding, no direct complications occur, except for cosmetic concerns. The complications of the underlying disease resulting in clubbing may be numerous considering the wide spectrum of diseases that are associated with clubbing. The discussion of these is beyond the scope of this article.

Patients with hereditary hemorrhagic telangiectasia may have develop pulmonary arteriovenous malformations, which may induce clubbing, cyanosis, and other findings, possibly leading to complications such as stroke or brain abscess if untreated. [49]