Tennessee Medicine E-Journal


A 58-year-old man presented to the clinic with a simple gastroenteritis. He was found to have a striking bilateral fingers and toes clubbing (Figure 1). The patient reported having this deformity since childhood. He is a non-smoker, and denied any concurrent cardiopulmonary disease, arthralgia, or bone deformity. Physical examination was otherwise unremarkable including normal heart and lung findings. EKG, Chest X-ray, blood gases, chemistry panel, and blood count were unremarkable. X-ray failed to show any bony overgrowth or periosteal reaction.

What is the most likely diagnosis? What would be your management, and what would you tell the patient?