Punching in the finger: symptoms, causes, diagnosis and treatment


Finger bumps, also described as hypertrophic osteoarthropathy (GOA), are enlargement of the fingertips with downward flexing of the nails. You may have a primary homeowners association, which is simply the sight of your fingers that is not associated with any health concerns. Or you can develop a secondary glomerulus caused by health problems like lung cancer and heart disease .

Desherinka / WIkimedia Commons / CC BY-SA 4.0

The cane itself is not harmful, but because it can be a sign of disease, it is important that your medical team determine the cause and treat you for the underlying condition.

Also know as

Clubs are also called finger clubs, digital sticks, glass watch nails, shin toes, Hippocrates toes, Hippocrates nails.

Get Medical Information / Jessica Olah


Clubs can involve fingers and / or toes. It is usually bilateral (affects both arms and / or legs) and must be the same length on both sides.

If you or your child have a primary HOA , then the fingers or toes may naturally appear large, bulging, and rounded. This will be noticeable during childhood or adolescence and will not change much over time. In a primary HOA, other family members may also touch their toes and / or toes .

Secondary blows with truncheons occur gradually and cause a change in the appearance of the fingers and toes.

With a secondary club caused by illness, you will also have other traits that the primary club does not have.

The characteristics of secondary club life include:

  • Soften nails
  • Nail beds that become soft and fluffy.
  • Nails that appear to "float" rather than fit snugly against the toes.
  • The disappearance of the angle between the nails and the cuticles.
  • Enlargement or bulge of the distal toe (where the toe meets the nail)
  • Warm red nail beds
  • The nails are curved downwards and look like the bottom of a round spoon.

Over time, the nail and the skin around the nail may become shiny and grooves will appear on the nail .


Primary club fighting is hereditary and passed on through genes. Hereditary clubbing is simply a physical trait, such as the color of your eyes or your height. Several genes have been associated with the primary hippocampus, including the HPGD gene and the SLCO2A1 gene .

Secondary blows with clubs occur as one of the consequences of chronic lung and heart disease. Lung cancer is the most common cause of clubbing. This symptom is also associated with a number of other chronic conditions, including conditions that affect the thyroid gland or digestive system .

There are a number of health risk factors associated with secondary clubs, including :

  • Lung cancer
  • Interstitial pulmonary fibrosis
  • Lung abscess
  • Pulmonary tuberculosis
  • Lung lymphoma
  • Chronic heart failure
  • Infectious endocarditis
  • Cyanotic congenital heart disease
  • Bronchiectasis
  • Cystic fibrosis
  • Other types of cancer, including liver, gastrointestinal, or Hodgkin's lymphoma.
  • Inflammatory bowel disease
  • Liver cirrhosis
  • Gastrointestinal neoplasms
  • Celiac Disease
  • Dysentery
  • Graves disease
  • Overactive thyroid

How does the disease affect the nail beds?

Diseases that can cause entanglement are generally associated with a decrease in oxygen levels . Experts suggest that clubbing occurs when your body undergoes changes in response to a lack of oxygen.

Various processes affect the nail beds in the secondary club. Nail enlargement occurs due to overgrowth of excess soft tissue under the nail beds. The increase is associated with inflammation and proliferation of small blood vessels in the nail bed .

A protein called vascular endothelial growth factor stimulates the growth of blood vessels, and this protein is believed to be an important factor in the physical changes that occur in clubs .


Clubs can be invisible, so it can be difficult for you and your healthcare team to verify this change in your numbers.

There are several objective criteria that are used to measure club activity and can help determine if you have developed this physical change:

  • Lovibond Profile : Typically, there is an acute angle between the nail bed and the cuticle. When you have a stick, the natural angle is lost when the nail is tilted down instead of up.
  • Distal / Interphalangeal Joint Depth Ratio : The toe phalanges are the areas between each bent joint. Its distal phalanx, which contains the nail, is usually shorter in depth than the adjacent phalanx. Clubs are listed when the opposite occurs.
  • Chamroth's sign : The acute angle between the nail bed and the cuticle forms a small diamond-shaped hole when you put your hands together with the nail tips facing each other. When this gap disappears, it is described as a sign of Shamroth .

Assessment of basic conditions

Club life often develops due to a chronic illness that was diagnosed many years before its onset. When your numbers start to skew, your healthcare team will evaluate you to identify any underlying medical conditions that may be causing it.

Even if you have established heart or lung disease, your health care team will evaluate your condition for any progression that may require adjustments to your treatment.

Tests you may need to evaluate club activity include :

  • A physical exam to look for signs such as weight loss, shortness of breath, skin changes, changes in heart rate, or blood pressure.
  • Blood Oxygen Pulse Oximeter
  • Pulmonary function tests (PFT)
  • Arterial blood gas analysis
  • Chest imaging tests, such as a chest X-ray or chest computed tomography (CT) scan.
  • Blood tests, including complete blood count (CBC), electrolyte levels, liver function tests (LFT), and / or thyroid tests.
  • An electrocardiogram (ECG) or echocardiogram to assess heart function.
  • Imaging tests of the abdomen, such as CT scan or ultrasound.
  • Biopsy if there is a dangerous lesion on the image.

Watch out

In general, the irregular shape and size of the fingers do not cause health problems, but any underlying disease that causes tuberosity requires medical and / or surgical treatment, as the case may be. Therapies can prevent the deterioration of your club's performance and, in rare cases, can completely alter some or all of your physical characteristics .

There are many approaches that are used to treat the root cause of clubbing. Your treatment will depend on your situation. You may need treatment for respiratory diseases, treatment for heart disease, or interventional cancer therapy.

Treatment may include:

  • Anti-inflammatory treatment of inflammatory conditions, including certain diseases of the lungs and gastrointestinal tract.
  • Hormone replacement
  • Pacemaker implantation to improve heart function

Get the word of drug information

If you notice your fingers chattering, be sure to discuss this with your doctor. Clubs can be diagnosed in your PCP's office. While clubbing themselves are harmless and require no treatment, they are often associated with a health condition that can worsen without treatment.

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