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Lung India Official publication of Indian Chest Society  
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LETTER TO EDITOR
Year : 2012  |  Volume : 29  |  Issue : 1  |  Page : 89  

Bedside evaluation of clubbing


Department of Tuberculosis and Respiratory Diseases, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India

Date of Web Publication28-Jan-2012

Correspondence Address:
Sajal De
Department of Tuberculosis and Respiratory Diseases, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra
India
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DOI: 10.4103/0970-2113.92377

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How to cite this article:
De S. Bedside evaluation of clubbing. Lung India 2012;29:89

How to cite this URL:
De S. Bedside evaluation of clubbing. Lung India [serial online] 2012 [cited 2014 Dec 18];29:89. Available from: http://www.lungindia.com/text.asp?2012/29/1/89/92377

Sir,

I read with interest the recently published article by Mukherjee et al. [1] The bedside diagnosis of low grade clubbing by subjective assessment of finger especially that of hyponychial angle is difficult and the inter-observer agreement is highly variable (κ = 0.39 to 0.90). [1] Objective assessment of clubbing can be done by using cast of finger, use of slide caliper on living finger (to measure the phalangeal depth), or by the shadowgram technique. Myers and co-worker systematically reviewed the literature for precision and accuracy of clinical examination of clubbing and recommended to use the profile angle and phalangeal depth ratio (>1) as qualitative indices. [2] In the present article, the authors used the complicated shadowgram technique to measure the clubbing. However, the image of a finger can be easily captured by a digital camera (most of our mobile phones have the digital camera) at bedside and this image can be analyzed in a computer. The hyponychial angle, which is commonly assessed at bedside can be better measured from digital image. [3] The authors also did not mention references in [Table 1].

 
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1.Mukherjee A, Bhattacharyya P, Saha I, Paul R. Evaluation of a simple bedside tool developed to measure different parameters of clubbing. Lung India 2011;28:228-9.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Myers KA, Farquhar DR. The rational clinical examination. Does this patient have clubbing? JAMA 2001;286:341-7.  Back to cited text no. 2
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3.Husarik D, Vavricka SR, Mark M, Schaffner A, Walter RB. Assessment of digital clubbing in medical inpatients by digital photography and computerized analysis. Swiss Med Wkly 2002;132:132-8.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  



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1 Authoręs reply
Mukherjee, A., Bhattacharyya, P., Saha, I., Paul, R.
Lung India. 2012; 29(1): 89-90
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