CLUBBING OF THE FINGERS
Ask the following questions:
- Is there cyanosis? Cyanosis should make one think of cyanotic congenital heart disease and pulmonary arteriovenous aneurysms.
- Is there a cough or dyspnea? A cough or shortness of breath should make one think of a pulmonary condition such as bronchiectasis, chronic interstitial fibrosis, asbestosis, emphysema, or carcinoma of the lung. Lung abscesses and tuberculosis must also be considered, although they are less frequent.
- Is there a fever? A fever along with the clubbing should make one think of empyema, lung abscess, tuberculosis, or subacute bacterial endocarditis.
DIAGNOSTIC WORKUP
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.
Book Source Details
- Book Title: Algorithmic Diagnosis of Symptoms and Signs
- Author(s): R. Douglas Collins
- Year of Publication: 2003
- Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.
Other Book Chapters Related to Finger symptoms
Read excerpts from these other book chapters related to Finger symptoms:
Medical Books Excerpts
- Clubbing
- "In A Page: Pediatric Signs and Symptoms" (2007)
- [ read ]
- Clubbing
- "Handbook of Signs & Symptoms (Third Edition)" (2006)
- [ read ]
- Clubbing
- "A Pocket Manual of Differential Diagnosis" (1999)
- [ read ]
- Clubbing
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Clubbing
- "Nursing: Interpreting Signs and Symptoms" (2007)
- [ read ]
Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.
More About Causes of Finger symptoms
» Next page: Clubbing (In A Page: Pediatric Signs and Symptoms)
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