26 year old male non smoker c/o clubbing of both upper n lower limb fingers since 1 year no c/0 . kindly diagnose n how to evaluate further

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Acquired bilateral clubbing is the most common form. It usually begins in the thumb and index fingers and is most often associated with pulmonary or cardiovascular diseases, including lung cancer, interstitial pulmonary fibrosis, lung abscess, pulmonary tuberculosis, pulmonary lymphoma, congestive heart failure, infective endocarditis, and cyanotic congenital heart disease . Less frequently, digital clubbing may occur in patients with extrathoracic disease, including inflammatory bowel disease, liver cirrhosis, and gastrointestinal neoplasms
Thank you sr

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Cause clubbing of fingers are 1 lungs disease A. Bronchiactesis B. Lungs any types melingnacy. But pt. Is young so less chance C. Vit. B12 deficiency D. Congenital and hereditary So investigation must require.You go for 1. CXR 2. Investigate for B12 3. Take family history for hereditary
No family h/o SR Chest x ray is normal Will advise vit b12
Genetic or familial cause of clubbing less likely with this drum stick sort of clubbing. Underlying cyanotic heart disease, bronchiectasis to look for. Infective causes like lung abscess, empyema, infective endocarditis unlikely as it developed over 1 yr. Baseline CXR, 2D Echo must. Malignancy, although unusual at this age, can't be excluded at this point.
Thank you sr
Hypoxia cause opening of deep AV fistulae of the terminal phalanx cause clubbing
If you rule out all the causes and pathology mentioned in the comments, you can stamp it as idiopathic. Ruled out pseudoclubbing...? What's the status of the lovibonds angle..? Xray done...?
X ray not done advised 2d echo Chest x ray is normal

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Clubbing is in lung cardiac kidney failure do lft rft 2decho cbc for anamia
I agree with Dr A Gupta
99% at RA

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