clubbing.pptx

CAUSES OF CLUBBING,THEORIES OF CLUBBING,GRADES OF CLUBBING

1. CLUBBING Dr.G.VENKATARAMANA MBBS DNB FAMILYMEDICINE

2. Phalangeal Depth Ratio Ratio of distal phalangeal depth (DPD) with interphalangeal depth (IPD) <1 is normal, >1 is suggestive of clubbing Digital Index Sum of phalangeal depth ratios of 10 fingers A digital index of 10.2 or higher is indicative of clubbing. Although, a phalangeal depth ratio of 1.0 or greater in any finger is suggestive of clubbing, digital index is more specific for clubbing

3. What are the respiratory causes of clubbing? A . Bronchogenic carcinoma (rare in adenocarcinoma) B . Metastatic lung cancer C. Pleural mesothelioma D. Suppurative lung disease 1 . Bronchiectasis 2. Cystic fibrosis 3. Lung abscess 4. Empyema E. Interstitial lung disease F . Longstanding pulmonary tuberculosis G. Chronic bronchitis H . Neurogenic diaphragmatic tumour I. Pulmonary AV malformation J. Sarcoidosis

4. What are the other causes of clubbing? Syphilis Syringomyelia Acromegaly Thyrotoxicosis Congenital/Familial Occupational/Traumatic Pachydermoperiostitis

5. Reverse differential clubbing : Upper limb (clubbing) Lower limb (N) PDA + transposition of the great arteries (TGA) + reversal of shunt Pseudoclubbing Leprosy Leukemic infiltration Hyperparathyroidism Thyroid acropachy Sclerodactyly Exposure to vinyl chloride Subungual tumors or cys ts Unidigital clubbing Tophaceous gout Local injury Sarcoidosis