Study - Finger Clubbing

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I

just found this study……….

Gut, Vol

22, 203-206, Copyright © 1981 by BMJ

Publishing Group

Prospective study of periostitis

and finger clubbing in primary biliary cirrhosis and other forms of chronic

liver disease

O Epstein, R

Dick and S Sherlock

The association

of finger clubbing and periostitis has been reported

in primary biliary cirrhosis and, more rarely, in other forms of

chronic liver disease. The prevalence of periostitis

and its relationship to finger clubbing is unknown. In this

prospective study, we have determined the prevalence of periostitis and finger clubbing in 74 patients with primary

biliary cirrhosis and 54 with other forms of chronic liver disease. Clubbing

was present in 24% of patients with primary biliary cirrhosis, 29% with

HBsAg negative chronic active hepatitis, and 23% in

the group of miscellaneous liver diseases. Symmetrical periostitis affecting the tibiae and fibulae

occurred in 35% of patients with primary biliary cirrhosis, 29% with

chronic, active hepatitis and 40% of patients in the miscellaneous group.

The distal radii and ulnae were affected in only eight patients (6%).

In primary biliary cirrhosis, the presence of finger clubbing was strongly

associated with periostitis (P less than 0.01), but

this association was uncommon in other forms of chronic liver

disease. In all forms of chronic liver disease periostitis

commonly occurs in the absence of finger clubbing. Marked tenderness

over the distal leg bones is a reliable sign of underlying periostitis, but this sign is present in only a third

of affected patients. This study indicates that periostitis

affecting the lower leg bones is common in patients with chronic

liver disease, and its presence should be sought whether or not the

patient has finger clubbing.

Barb

in Texas - Together in the

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Son Ken (32) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas