Clubbed fingers, 25yr male,no hereditary history, symptomless, pulmonary and etc reasons ruled out- all parameters WNL . what may be the cause . or ??? idiopathic


if pt is asymptotic den why r u thinking of cirrhosis,ulcerative colitis can be ideopathic.
I agree with dr vishal there is no need to subject the patient to ct abdomen young male, risk of radiation and colonoscpy in the absence of symptoms. if u want to rule out IBD do crp levels though it is nonspecific it indicates inflammation in body. more over copd do not cause clubbing suppurative lung disorders and malignancy causes clubbing, hrct is done only if u suspect old and bronchectasis not for copd. rule out pulmonary av fistula is he is saturation is low on pulse oxy. pt may be asymptomatic . hardly we see cases of inflammation bowel disease with clubbing. it can be congenital clubbing.
idiopathic is a diagnosis of exclusion... It mean that u have to rule out Every possible reason before you can say its primary/Idiopathic/cryptogenic or whatever nonsense... Idiopathic may mean either you couldn't find the cause or its not there... But you won't be sure which one it is until you've ruled out all possible commoner cuses
why did you do an HRCT to R/o pulmonary pathology? HR would miss a small pathology... Now you should get a workup for Cirrhosis of liver... If not then only causes left I guess are GI- Ulcerative colitis/Crohn's/Lymphoma
Even I also don't think to push pt for more unnecessary expenses....... i think it's better to take clinical f/u every 3 months, and if asymptomatic - leave it labeling idiopathic....... please correct if I am wrong..
no symptoms at all n primary workup normal still thinking of cirrhosis in 25 yr male n advicing CT abd, colonoscopy is irrelevant i think....investigations should b relevent to symptoms.
hi, he is neither polycythemic nor hypoxic. and had clubbing since last 5-6 yrs no congenital..... clinical judgement doesn't support suspicion of bowel pathology as well...
Well now that's a valid argument... although I don't think there would be chronic hypoxia in athletes to cause polycythemia... but atleat now we r looking for a cause
LFT , USG are normal. further GI work up is needed I agree.... But I would like to mention that pt is national level athelet with no symptoms at all.
@Dr Vishal its the difference in the thinking pattern of Physicians vs Intensivists I guess ... We tend to exclude "IDIOPATHIC" from our list of D/D
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