Drumstick fingers

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

More about the experts All content is checked by medical journalists.

The term drumstick finger refers to piston-like thickenings or swellings of the finger end phalanx with soft tissue swelling. This is often associated with watch glass nails, i.e. nails that are excessively arched in the longitudinal direction. Drumstick fingers can occur in various diseases, such as those of the lungs, heart, liver or the gastrointestinal tract. Here you can read everything you need to know about the causes and therapy of drumstick fingers.

Brief overview

• What are drumstick fingers? piston-like thickenings on the phalanxes of the fingers, often combined with watch glass nails (nails that bulge excessively in the longitudinal direction)
• Causes: mostly lung or heart diseases (lung cancer, pulmonary fibrosis, chronic heart failure, etc.), sometimes other diseases such as the liver or gastrointestinal tract (hepatitis, inflammatory bowel disease, etc.)
• What to do with drumstick fingers? always to the doctor, as it is often caused by a serious illness
• Treatment: Therapy of the underlying disease, which then usually also causes the drumstick fingers to recede

Drumstick finger: description

As drumstick fingers (drumstick fingers) or piston fingers, medical professionals refer to fingers whose end links are expanded like a piston and have a soft tissue thickening. In addition, the fingernails are often excessively bent lengthways ("watch glass nails").

Drumstick fingers can appear unilaterally or bilaterally, be congenital or acquired. They are signs of a chronic lack of oxygen (hypoxia) in peripheral areas of the body, i.e. regions remote from the trunk. The reason for this is often lung or heart disease. But there are other possible causes of drumstick fingers as well.

Drumstick fingers: causes and possible diseases

Piston fingers usually appear on both hands (double-sided). One-sided drumstick fingers are less common. The most important causes in both cases are listed below.

Double-sided drumstick fingers: causes

Lung disease

Double-sided drumstick fingers with watch glass nails are often due to a lung disease such as:

• Lung cancer (bronchial carcinoma): most common cause of double-sided drumstick fingers with watch glass nails
• Bronchiectasis (sac-shaped expansions of the bronchi that cannot regress)
• Emphysema (overinflation of the small alveoli)
• Pulmonary tuberculosis (bacterial infection of the lungs)
• Pulmonary fibrosis (increase in connective tissue fibers in the lungs)
• Cystic fibrosis (a congenital metabolic disorder in which a lot of thick mucus is produced, especially in the airways)

Heart disease

In some cases, drumstick fingers can be traced back to a chronic heart failure (heart failure) or certain heart defects (e.g. the congenital heart disease Fallot tetralogy). Heart tumors and inflammation of the inner lining of the heart (endocarditis) are also possible causes.

Liver disease

Drumstick fingers can also develop as part of cirrhosis of the liver. In this chronic liver disease, the liver tissue gradually dies and is replaced by scar tissue and connective tissue. In most cases, the cause is a virus inflammation of the liver (viral hepatitis) or excessive alcohol consumption.

Gastrointestinal diseases

Various digestive tract diseases can also trigger drumstick fingers, for example:

• chronic inflammatory bowel disease (Crohn's disease, ulcerative colitis)
• intestinal tuberculosis (a type of tuberculosis that manifests in the digestive tract)
• Polyposis of the colon (numerous polyps in the colon)
• chronic amoebic dysentery
• Colon cancer
• Cancer of the lymph glands in the abdomen (abdominal Hodgkin's disease)

Other causes

Sometimes double-sided drumstick fingers appear after surgical removal of the whole thyroid gland (thyroidectomy). Other possible causes are, for example, tumors in the throat area and chronic bone inflammation (osteomyelitis) with amyloidosis. This is understood to mean the deposition of modified proteins between the body cells.

Unilateral drumstick fingers: causes

Possible causes for one-sided piston fingers are, for example:

• Aneurysm (sac-shaped expansion of the arterial wall), for example in the area of ​​the aortic arch (section of the main artery close to the heart) or in the subclavian artery (subclavian artery)
• Lymphangitis (inflammation of the lymphatic system)
• Pancoast tumor (special form of lung cancer)

Drumstick fingers: what to do?

Since drumstick fingers can be a symptom of various, mostly serious diseases, they should always be clarified by a doctor. You should see a doctor immediately, especially if you have other symptoms (such as shortness of breath, coughing or decreased performance)!

Investigations

The doctor will first take a detailed discussion with you about your medical history (anamnesis). For example, he asks about all of your symptoms as well as previous illnesses (such as recurrent pneumonia) and your nicotine consumption.

During the subsequent physical examination, the doctor examines the drumstick fingers and (if available) the watch glass nails. He listens to the chest and pays attention to heart murmurs and rattle noises in the lungs. Doctors also look for signs of anemia, such as pale sclera (the white part of the eye) and mucous membranes.

Laboratory tests are also important to determine the cause of drumstick fingers. The doctor can determine the lack of oxygen by means of a blood gas analysis. He can also take a differential blood count (determination of the different types of leukocytes) and measure other blood values ​​such as creatinine, urea, blood salts (electrolytes), liver and thyroid values.

There are also other tests that can help to find out the cause of drumstick fingers. This includes

• Chest x-ray (chest x-ray)
• Ultrasound examination of the heart (echocardiography)
• Pulmonary function test
• Analysis of the sputum (sputum diagnostics)
• Lungoscopy (bronchoscopy)

treatment

The doctor does not treat drumstick fingers directly, but rather focuses the medical measures on the underlying cause, such as lung or heart disease. Once this has been remedied, the drumstick fingers usually also recede.

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