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October 24/31, 2001

Clinical Description of Nail Clubbing

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(16):1972-1973. doi:10.1001/jama.286.16.1969

To the Editor: In their article on clubbing, Drs Myers and Farquhar1 imply that "advanced" and "early" clubbing might be used as quantitative terms. However, the terms to describe the clubbing are not standardized. Should we just use early and advanced (does early clubbing mean that it will become advanced with time?) or grade the clubbing like heart murmurs? It might be useful to have some standard rather than, for example, "present" or "absent," or "acute" and "chronic." Once present, does clubbing often go away? I have seen clubbing in a patient with lung cancer and when the cancer was "cured" with surgery, the clubbing disappeared only to return with recurrence of the tumor.