Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentFAQ
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
FAQ
Clubbed fingers describefingernails or toenailsthat are curved downward, like a spoon. The nails may feel soft when pressed and no longer sit even with the cuticle. This often occurs along with swelling or bulging of the tips of the fingers or toes.
Clubbed fingers can be a symptom of conditions such as lung cancer, heart defects, or digestive conditions including cystic fibrosis or celiac disease. Clubbing usually happens because of long-term low levels of oxygen in the blood, known ashypoxemia.
However, clubbed nails are not always cause for alarm, especially if nail clubbing runs in your family.
This article covers the causes and symptoms of clubbed fingers, along with how clubbed fingers are diagnosed and treated.
Desherinka/ WIkimedia Commons / CC BY-SA 4.0
Also Known AsClubbed fingers are also referred to as hypertrophic osteoarthropathy (HOA), digital clubbing, watch-glass nails, drumstick fingers, Hippocratic fingers, and Hippocratic nails.
Also Known As
Clubbed fingers are also referred to as hypertrophic osteoarthropathy (HOA), digital clubbing, watch-glass nails, drumstick fingers, Hippocratic fingers, and Hippocratic nails.
Finger Clubbing Symptoms
Clubbing can involve your fingers and/or toes. It is typically bilateral (affecting both hands and/or feet) and it should be equal in terms of its extent on both sides.
Clubbing happens gradually and causes a change in the appearance of your fingers and/or toes. Clubbed nails become red, sponge-like, and swollen, almost like tiny balloons. From close up or a distance, clubbed nails resemble upside-down spoons.
These gradual changes may occur alone or with other symptoms, such as shortness of breath or coughing.
Verywell / Jessica Olah
Features of secondary clubbing include:
Eventually, the nail and skin around the nail may become shiny, and the nail develops ridging.
If you notice signs of nail clubbing, make an appointment with your healthcare provider. Clubbed nails can be a sign of a serious condition, so it’s important to have them evaluated right away.
Is Finger Clubbing Painful?
Causes of Clubbed Fingers
There are two types of clubbed fingers, nails, or toes with one type typically being a sign of severe disease.
Primary (idiopathic) clubbing,also calledhypertrophic osteoarthropathy(HOA), is hereditary and is passed down via genes. Hereditary clubbing is simply a physical feature, like eye color and height. Several genes have been associated with primary clubbing, including the HPGD gene and the SLCO2A1 gene.Clubbing occurs alone, without an underlying health condition, and is a rare inherited trait—accounting for just 3% of all clubbing cases.
If you or your child hasprimary HOA, then your fingers or toes may naturally appear large, bulging, and rounded. This will be noticeable during childhood or during the teenage years, and it will not change much over time. With primary HOA, other family members are also likely to have finger clubbing and/or toe clubbing.
Secondary clubbing is often related to a heart or lung condition, such as:
Does Smoking Cause Clubbed Fingers?Yes, chronic smoking blocks oxygen from getting to tissues, including fingernails. Over time, this can lead to the growth of bone-forming and connective tissue-forming cells in the nails that causes finger clubbing.
Does Smoking Cause Clubbed Fingers?
Yes, chronic smoking blocks oxygen from getting to tissues, including fingernails. Over time, this can lead to the growth of bone-forming and connective tissue-forming cells in the nails that causes finger clubbing.
Sometimes secondary nail clubbing can have causes that are unrelated to the heart or lungs, such as:
Is Finger Clubbing Rare?The most common cause of secondary finger clubbing is lung cancer, however, only 5% to 15% of people with lung cancer develop clubbed fingers. Primary finger clubbing is far more rare.
Is Finger Clubbing Rare?
The most common cause of secondary finger clubbing is lung cancer, however, only 5% to 15% of people with lung cancer develop clubbed fingers. Primary finger clubbing is far more rare.
How Clubbing Affects Nail Beds
The medical conditions that can cause clubbing are generally associated withdecreased oxygen levels. Experts suggest that clubbing occurs as your body undergoes changes in response to low oxygen.
Several processes affect the nail beds in secondary clubbing. The nail enlargement occurs due to the growth of excess soft tissue beneath the nail beds. The enlargement is associated with inflammation and a proliferation of small blood vessels in the nail beds.
A protein calledvascular endothelial growth factor (VEGF)stimulates the growth of blood vessels, and this protein is considered a major factor in the physical changes that occur in clubbing.
Diagnosing Clubbed Fingers
Clubbing can be subtle, so it may be difficult for you and your medical team to verify this change in your fingers or toes.
There are a few objective criteria that are used to assess clubbing, and they can help in determining whether you have developed this physical change:
Tests
If your healthcare provider decides you have clubbing, their first move will be to ask about your family history. They’ll be interested to know if it’s a hereditary trait.
The provider will then do a careful history and physical exam, keeping in mind the possible causes associated with secondary clubbing. Depending on your symptoms, the tests may include:
The next move, if any, will depend on what your healthcare provider discovers.
Chronic kidney disease and other disorders such assystemic sclerosismay cause finger changes that mimic the appearance of digital clubbing. Additional tests may be needed to rule these out.
How Lung Cancer Is Diagnosed
Treatment for Clubbed Fingers
Usually, the abnormal shape and size of the digits do not cause health problems, but any underlying disease that causes clubbing needs to be medically and/or surgically managed, as appropriate. Treatments may prevent your clubbing from worsening and, in rare cases, can reverse some or all of the physical features of clubbing.
There are a variety of approaches used to treat the underlying cause of clubbing. Your treatment will depend on your situation. You may need management of respiratory disease, treatment of heart disease, or interventional therapy for cancer.
Summary
Pinpointing the cause of clubbing is important. Once the cause is treated, the clubbing should go away on its own.
If you notice clubbed fingers or toes, be sure to discuss this with your healthcare provider. Clubbing can be diagnosed in your healthcare provider’s office. Although clubbing itself is harmless and doesn’t require treatment, it is often associated with health conditions that can worsen without treatment.
Frequently Asked Questions
If the underlying cause of clubbed fingers is treated, yes, they can go away. Heart and lung diseases are the most common problems. These may need to be treated with medication or surgery.Learn MoreCOPD Symptoms
If the underlying cause of clubbed fingers is treated, yes, they can go away. Heart and lung diseases are the most common problems. These may need to be treated with medication or surgery.
Learn MoreCOPD Symptoms
There are five stages or grades of clubbing:Grade 1: The nail bed becomes soft.Grade 2: There are changes in the angle of the nail fold (the skin beneath the cuticle that holds the nail in place).Grade 3: The nail takes on a more obvious curve.Grade 4: The end of the finger becomes thicker (club-like).Grade 5: The nail takes on a shiny appearance.Learn MoreWhat Is Nail Pitting?
There are five stages or grades of clubbing:Grade 1: The nail bed becomes soft.Grade 2: There are changes in the angle of the nail fold (the skin beneath the cuticle that holds the nail in place).Grade 3: The nail takes on a more obvious curve.Grade 4: The end of the finger becomes thicker (club-like).Grade 5: The nail takes on a shiny appearance.
There are five stages or grades of clubbing:
Learn MoreWhat Is Nail Pitting?
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Medline Plus.Clubbed fingers.
American Academy of Dermatology Association.12 nail changes a dermatologist should examine.
Krugh M, Vaidya PN.Osteoarthropathy Hypertrophic. In:StatPearls. Treasure Island, FL: StatPearls Publishing, 2019.
Yuan L, Liao RX, Lin YY, et al.Safety and efficacy of cyclooxygenase-2 inhibition for treatment of primary hypertrophic osteoarthropathy: A single-arm intervention trial.J Orthop Translat. 2019;18:109-118. doi:10.1016/j.jot.2018.10.001
Sarkar M, Mahesh DM, Madabhavi I.Digital clubbing.Lung India. 2012 Dec;29(4):354-362. doi:10.4103/0970-2113.102824
Cancer Research UK.Finger clubbing.
Callemeyn J, Van Haecke P, Peetermans WE, Blockmans D.Clubbing and hypertrophic osteoarthropathy: insights in diagnosis, pathophysiology, and clinical significance.Acta Clin Belg.2016;71(3):123-30. doi:10.1080/17843286.2016.1152672
Jamieson A.The causes of finger clubbing: a list worth learning.Am J Med.2011;124(7):e1-3. doi:10.1016/j.amjmed.2011.01.020
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
