title: Idiopathic clubbing confined to lower limb digits and idiopathic pulmonary fibrosis: an unusual association.
abstract: A 62-year-old housewife presented to the chest outpatient department with a history of exertional breathlessness of four-month duration. On general physical examination, clubbing of toes was present with sparing of fingers. Chest examination revealed bilateral basal end inspiratory fine crepitations. A diagnosis of idiopathic pulmonary fibrosis was made on the basis of clinical, spirometric, and high-resolution computed tomography findings. Extensive evaluation could not reveal any cause for the differential clubbing. The unusual distribution of clubbing in a clinical condition, such as idiopathic pulmonary fibrosis, where generalized clubbing is expected can lead to a diagnostic confusion. This can lead to a further burden of investigations on the patient as clubbing being a significant finding cannot be ignored.
authors.affiliation: Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Karnataka, Manipal 576104, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Magazine
authors.forename: Ranjan
authors.initials: R
authors.lastname: Shetty
authors.forename: Umesh
authors.initials: U
authors.lastname: Goneppanavar
authors.forename: Aswini K
authors.initials: AK
authors.lastname: Mohapatra