Digital clubbing, or changes in the nails on your fingers and toes, is mostly a symptom rather than a disease itself. Treating clubbed nails means treating the underlying disease.
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.)
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.
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.
The signs and symptoms of clubbing of fingers and toes involve changes in the way your fingers and toes look.
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:
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.
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.
Your provider won’t really treat clubbed fingers. Your provider will treat the disease that causes the clubbing.
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.
The outlook for someone with clubbed fingers varies. Treating the disease that causes clubbing may make the clubbing go away.
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.
Last reviewed by a Cleveland Clinic medical professional on 08/04/2022.
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