Diagnostic Tests for Clubfoot
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CLUBBING OF THE FINGERS:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
An EKG and chest x-ray will identify the most common causes of clubbing. A CBC, sedimentation rate, and chemistry panel should also be done routinely. If there is fever, a sputum smear, culture and sensitivity, and blood culture should be done. An upper GI series, an esophagogram, and a barium enema will identify most GI disorders. Cyanotic congenital heart disease will require further workup, including a cardiology consultation, cardiac catheterization, and angiocardiography. A thoracentesis may be necessary to diagnose empyema. Sputum cytology is the first step if a neoplasm is suspected. Bronchoscopy may be necessary to diagnose carcinoma of the lung. A CT scan of the chest can be used to diagnose bronchiectasis.
If a more extensive workup is necessary, a referral to a pulmonologist or cardiologist should be considered.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Clubbing:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
You'll probably detect clubbing while evaluating other signs of known pulmonary or cardiovascular disease. Therefore, review the patient's current plan of treatment because clubbing may resolve with correction of the underlying disorder. Also, evaluate the extent of clubbing in the fingers and toes. (See Checking for clubbed fingers.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Clubbing:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
You’ll probably detect clubbing while evaluating other signs of known pulmonary or cardiovascular disease. Therefore, review the patient’s current plan of treatment because clubbing may resolve with correction of the underlying disorder. Also, evaluate the extent of clubbing in both the fingers and toes. (See Checking for clubbed fingers, page 182. )
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Nail Phenomena/Clubbing:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
Nails contain an archive of information about physiologic conditions affecting their growth, similar to the way tree rings record the weather of summers past. If examined closely, they may also contain the subtlest of clues to important
systemic illness, such as endocarditis.
Clubbing is most sensitively detected by loss of the normal nail angle when seen in profile, or by putting corresponding fingers back to back and looking for loss of the diamond of light. Springiness or ballotability of the base of the nail is another early sign. The overlying skin is smooth and shiny, and the nailbeds are cyanotic. Nails of patients with chronic paronychia may be confused with clubbing.
When clubbing is present, specifically examine for findings of associated illness including peripheral stigmata of endocarditis, murmurs, splenomegaly, jaundice, wheezes, rales, pleural effusion, supraclavicular adenopathy, hepatomegaly, abdominal mass, thyromegaly, and ophthalmopathy.
Unilateral clubbing may be caused by impairment of the vascular supply to the arm. Causes include aortic or subclavian artery aneurysm, anomalous aortic arch, pulmonary hypertension with patent ductus arteriosus, brachial arteriovenous fistula, superior sulcus lung tumor, and recurrent shoulder dislocation. Unidigital clubbing may be caused by median nerve injury or sarcoidosis. Clubbing of toes without fingers can be seen in coarctation of the aorta.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Clubbing:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
You'll probably detect clubbing while evaluating other signs of known pulmonary or cardiovascular disease. Therefore, review the patient's current plan of treatment because clubbing may resolve with correction of the underlying disorder. Also, evaluate the extent of clubbing in the fingers and toes. (See Checking for clubbed fingers.)
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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