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Daniel E. Leb, MD; Jashwant K. Sharma, MD

JAMA. 1978;240(2):142-143.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

DIGITAL clubbing has been defined as painless, uniform enlargement of a finger or toe confined to the terminal segment.¹ Although first described by Hippocrates and associated with a number of conditions, the pathogenesis remains obscure. The diagnosis is made by demonstrating that the normal angle between the plane of the proximal nail and the plane of the distal phalanx has been obliterated.^1,2 Clubbing of the thumb and index and middle fingers developed in a woman's arm in which a radial arteriovenous (AV) fistula for use in hemodialysis had been constructed.

Report of a Case

A 24-year-old woman with renal failure secondary to chronic glomerulonephritis and congenital absence of the left arm below midhumerus began hemodialysis in September 1971 using a leg shunt. An AV fistula was constructed but not used until August 1974. She received hemodialysis for 12 hours each week using a 1.3-sq m capillary dialyzer with . . . [Full Text PDF of this Article]

Author Affiliations
From the Division of Nephrology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh.

Footnotes
Reprint requests to Renal Unit, Presbyterian-University Hospital, 230 Lothrop St, Pittsburgh, PA 15213 (Dr Leb).

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