Rheumatology

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Pseudoclubbing: Is it different from clubbing?
Seminars in Arthritis and Rheumatism, 11/24/08

Santiago MB et al. – Although some characteristics have been noted in differentiating “pseudoclubbing” (PC) from clubbing, sometimes these features are not present.

• Review of literature to identify differences and similarities between clubbing and PC
• PubMed database (1950-2006) search; all published manuscripts and secondary references were examined
• An additional search using the keywords “clubbing” and “hypertrophic osteoarthropathy”

• Using the keyword “pseudoclubbing”, 10 articles-19 cases were identified
• 11 were associated with renal failure/secondary hyperparathyroidism, 3 with subungual hemangioma, 2 with chromosomal deletion, 1 with sarcoidosis, 1 with primary hyperparathyroidism, and 1 with scleroderma
• Of the 4 cases of PC, 3 associated with scleroderma and 1 with primary hyperparathyroidism are presented in this study
• No convincing etiopathogenic mechanism for PC was found
• Main features of PC were the asymmetric finger involvement, but not in all, and acro-osteolysis, although this feature may also occur in “true” clubbing

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