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Question
What is this physical finding?
Answer
Answer: Clubbing
Differential Diagnosis of Clubbing in Children:
- Cystic Fibrosis
- TB
- Sarcoid
- Cyanotic congenital heart disease
- Thyrotoxicosis
- HIV
- Malnutrition
- Empyema
- Hepatobiliary Disease
Clubbing was first documented by Hippocrates in a patient with empyema. It has been associated with cardiopulmonary disease, but also found in other disease processes such as hepatobiliary, infectious, and endocrine diseases. It can also occur without an underlying pathology. The pathophysiology behind these physical findings remain unknown. The workup and treatment should be aimed at managing the underlying cause.
University of Maryland Section for Global Emergency Health
Author: Van Pham, MD
References
Schwartz, Robert. Clubbing of the Nails. 3.12.14. http://emedicine.