Clubbed Fingers

What are clubbed fingers?

Clubbed fingers refers to the way the ends of your fingers look, including your nails and the areas around and under them. These appearances can happen with your toes as well. If clubbing happens, it usually affects both hands and/or both feet. Some people refer to clubbing of the fingers and toes as digital clubbing. (“Digits” is another name for your fingers and toes.)

What’s the difference between clubbed fingers and fingers that aren’t clubbed?

The tips of your fingers or toes bulge and may become warm and/or discolored. Finally, the nail curves down so that it eventually looks like an upside-down spoon. It may look like your nails are floating and aren’t really attached to your finger.

Who can get clubbed fingers?

Digital clubbing can happen to anyone. In most cases, it’s a symptom of another condition, but it can be idiopathic. Idiopathic means that there's no cause. Digital clubbing can also be congenital (something you’re born with) or hereditary.

Clubbing often indicates problems with your lungs, heart or digestive system. Clubbing usually happens because of long-lasting (chronic) low levels of oxygen in your blood, known as hypoxemia.

What are the signs and symptoms of clubbing of fingers and toes?

The signs and symptoms of clubbing of fingers and toes involve changes in the way your fingers and toes look.

• Your nails may look like they aren’t attached anymore.
• The angle where your nail meets the cuticle gets wider. Your nail may begin to look like a hill. (This situation is seen best from the side — in profile.)
• The tips become wide and round. They might also darken in color or become warm to the touch.
• The tips of your nails curve downward.

What causes clubbing of fingers and toes?

It may be that your toes and fingers are clubbed and there isn’t a disease causing the clubbing. If that’s true, the clubbing isn’t harmful. However, in most cases, your healthcare providers will check to make sure that there’s no other disease involved.

Many diseases related to clubbing involve your heart, lungs and digestive system. These conditions include:

Cancers related to digital clubbing

• Esophageal cancer.
• Gastrointestinal tumors.
• Liver cancer.
• Lung cancer.
• Lymphoma.
• Mesothelioma: A rare cancer that asbestos exposure causes.

Heart and lung conditions other than cancer related to digital clubbing

• Aortic aneurysm: A bulging in the wall of your body’s largest artery.
• Bronchiectasis: Scarred airways lead to coughing up mucus.
• Congenital heart disease: A structural issue with your heart that’s present at birth.
• Cystic fibrosis: An inherited disease that causes sticky mucus to build up in organs.
• Empyema: A collection of pus in a body cavity, most often your pleural cavity.
• Endocarditis: A bloodstream infection attacks the lining of your heart valves.
• Lung abscesses: A collection of pus in your lung that’s surrounded by swollen lung tissue.
• Idiopathic pulmonary fibrosis: Scarred and thickened lung tissue causes lung damage.
• Sarcoidosis: An inflammatory disease that may change the structure or function of organs, such as your lungs.

Other conditions related to digital clubbing

• Ascariasis. A roundworm infection of your intestines.
• Celiac disease. An autoimmune disease that can damage your small intestine.
• Cirrhosis, which is often a result of alcoholism. A liver disease in which scar tissue replaces healthy tissue.
• Inflammatory bowel disease. An inflammatory disease that damages your intestines.
• Thyroid disease. Conditions that stop your thyroid gland from working correctly.
• Overuse of certain drugs, including laxatives, interferon alfa-2A and prostaglandin infusion.

Is clubbing of fingers and toes contagious?

No, clubbed fingers aren’t contagious. Clubbed fingers may not even be a disease itself. It may be a sign or symptom of another disease. However, clubbed fingers can be a sign of a disease that's infectious.

How will your provider diagnose clubbed fingers?

Your healthcare provider will start with taking a medical history and doing a physical examination. There will often be clues in your history that will suggest why you have clubbing.

Your provider may measure the Lovibond angle or the Lovibond profile sign. Your provider will look at your finger from the side and measure the angle between your proximal nail fold (the part near the cuticle) and your nail bed. This angle on a clubbed nail is larger than 180 degrees and on a non-clubbed nail less than 180 degrees.

They may also ask you to press one finger against the same finger at the joint so that the nails are facing each other. Fingers without clubbing form a space between them shaped like a diamond, known as the Schamroth sign.

Your provider may also look at the angle measurement involving the skin under the nail at your nail tip, the nail bed, the area near the cuticle and the closest joint on your finger. This measurement, the hyponychial angle, refers to the skin under your nail, called the hyponychium.

Then your provider will order tests that will help to find out which disease is causing your clubbed fingers and/or toes. The tests will be different depending on the suspected cause.

Tests may include a chest X-ray. If the X-ray doesn’t show anything wrong, your provider may order a CT scan.

Other tests will be specific to the disease your provider suspects you may have. They might include other imaging tests, blood tests or biopsies.

How are clubbed fingers treated?

Your provider won’t really treat clubbed fingers. Your provider will treat the disease that causes the clubbing.

How can I reduce my risk of developing clubbed fingers?

You can’t prevent being born with clubbed fingers or toes. You may be able to reduce your risk of developing diseases that may lead to digital clubbing.

For instance, you may reduce your chances of getting certain lung and heart diseases by not smoking. You may reduce your chances of developing cirrhosis by not drinking alcohol to excess.

What can I expect if I have clubbed fingers?

The outlook for someone with clubbed fingers varies. Treating the disease that causes clubbing may make the clubbing go away.

When should I see my healthcare provider?

If you develop any symptoms related to nail changes, contact your healthcare provider. If your provider has diagnosed a disease related to the nail clubbing, follow their treatment suggestions. In any case, always discuss anything that worries you with your provider.

A note from Cleveland Clinic

You know your body best. If you’re born with clubbed fingers and toes, you won’t have to treat them. They won’t cause you problems. If your fingers and toes begin to change, make an appointment with your provider so they can assess the changes. Get the information you need. You’re the most important factor in getting and keeping well. Your provider is your trusted partner.