Physical Exam: Pulmonary
Clubbing of Nails
Clubbing results from a build up of material under the proximal nail bed resulting in a loss of the normal oblique angle between the nail and the cuticle.
- The angle can be observed by placing the thumbs together nail to nail, knuckle to knuckle. If the angle is normal, there is a diamond space between the thumbs.
- Normally, the diameter of the digit at the cuticle should be less than at the knuckle.
- In clubbing, the nail bed develops a sponginess that may be appreciated prior to the loss of angle.