Finger clubbing

Finger clubbing means there are certain changes in the shape of your fingers and fingernails. It is also called digital clubbing or Hippocratic fingers. People with conditions such as heart or lung problems sometimes have these changes.

What is finger clubbing?

Finger clubbing usually affects the top of the fingers on both hands. And can also affect toes. It seems to happen in stages:

  • there is softening of the base of the nail (nail bed) and redness (erythema) of the skin around the nail
  • the angle between the nail bed and the nail fold (the skin just below the cuticle) increases, which causes the nail to curve more than usual
  • the nail and the skin around the nail look shiny, and the nail has ridges along the length of it
  • the ends of the fingers look larger, giving the ‘clubbed’ appearance

Finger clubbing generally takes years to develop. But it can happen quicker in certain conditions such as a lung abscess.

Hypertrophic pulmonary osteoarthropathy (HPOA)

In the later stages of finger clubbing, extra areas of bone might form on the finger joints, wrists and ankles. This is sometimes mistaken for arthritis and is called hypertrophic pulmonary osteoarthropathy (HPOA).

Who can get finger clubbing?

Finger clubbing can be a sign of a number of underlying health conditions, particularly of the lungs or heart. This includes cancers such as lung cancer and mesothelioma. But finger clubbing can also be found in some people with thyroid problems or other conditions such as ulcerative colitis and Crohn’s disease. Many people with these conditions don’t have finger clubbing.

What causes finger clubbing?

It is not clear what causes finger clubbing. It may be due to large cells called megakaryocytes getting stuck in the small blood vessels in the tips of the fingers. Megakaryocytes are usually in the bone marrow Open a glossary item and make platelets, which we need for blood clotting.

When stuck in the fingertips, the megakaryocytes start to release growth factors which lead to an increase in blood vessels and tissue growth, and a build up of fluid.

Finger clubbing is unusual. If you think you might have it and are worried, do speak to your doctor. They can examine you and find out about any other symptoms you might have. They can send you for tests if necessary, such as a chest x-ray to check your lungs.

  • Assessment of clubbing
    BMJ Best Practice - accessed March 2021

  • Oxford Handbook of Clinical Medicine (10th edition)
    IB Wilkinson, T Raine, K Wiles and others
    Oxford University Press, 2017

  • Clubbing: An update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance
    KE Spicknall and others
    Journal of the American Academy of Dermatology, 2005. Volume 52, Issue 6, Pages 1020 - 1028

  • Clubbing in patients with fibrotic interstitial lung diseases
    MJG van Manen and others
    Respiratory Medicine, Volume 132, November 2017, Pages 226-231

Last reviewed: 
29 Jun 2023
Next review due: 
29 Jun 2026

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