손가락 곤봉지 또는 발가락 곤봉지(곤봉상지), Clubbing of fingers or toes

손가락 곤봉지 또는 발가락 곤봉지(곤봉상지), Clubbing of fingers or toes

• 손가락 말단 마디 손톱 밑 골막의 섬유조직과 혈관들이 비후해지고 과대 형성되고 그 부분의 골이 새로 형성되어 손가락의 말단이 둥글게 생기 징후를 곤봉상지 또는 곤봉 손가락이라 한다. 발가락 말단 마디에도 같은 현상이 생길 수 있다.ㄱ
• 곤봉상지의 정도에는 차이가 많다. 
• 원인은 다음 표를 참조한다. 
• 치료는 원인되는 병을 치료한다.

선천성 심장 질환	후천성 기관 폐질환	후천성 심장 질환	후천성 위장관 질환	전염병	내분비 질환	유전성 근육골격 질환
선천성 심장기형, 보통으로 청색형	원발성 종양, 전이성 종양, 늑막 종양 만성 감염병-폐결핵, 폐농양, 기관지 확대증 원발성 질환-폐 섬유증, 낭포성 섬유증, 사르코이도증	대동맥류, 심장부전증, 박테리아성 심내막염	염증성 장질환, 악성종양, 감염병, 아메바증, 회충증 간질환-만성 활동성 간염, 간경화증	에이즈, 동맥 이식 패혈증	이차성 갑상선 질환, 원발성 갑상선 항진증	경피골막증

 

Clubbing of fingers or toes

• Fingertip joint The fibrous tissue and blood vessels of the periosteum under the nail are thickened and over-formed, and new bone is formed in that part, resulting in round fingertips, called club fingers or club fingers. The same thing can happen to the distal joint of the toe.

• The degree of clubbing varies widely.

• Refer to the following table for the cause.

• Treatment treats the cause of the disease.

Picture 611. Long club finger. Due to cyanotic heart disease, chronic gastrointestinal disease, or lung disease, the knuckles at the tips of fingers or toes may become enlarged in the shape of a club as shown in the picture. Copyrightⓒ 2012 John Sangwon Lee, MD., FAAP

Photo 612. Long club finger. Due to cyanotic heart disease, chronic gastrointestinal disease, or lung disease, the knuckles at the tips of the fingers or toes may become enlarged in the shape of a club as shown in the picture. Copyright© 2012 John Sangwon Lee, MD. FAAP

Table 19. diseases with Clubbing of fingers or toes

congenital heart disease	후천성 기관 폐질환 Acquired organ tracheo lung disease	후천성 심장 질환 acquired heart disease	acquired gastrointestinal diseases	infectous disease	endocrine disease	hereditary musculoskeletal disorders
Congenital heart anomalies, usually blue	Primary tumor, metastatic tumor, pleural tumor Chronic infectious diseases – pulmonary tuberculosis, lung abscess, bronchiectasis Primary diseases – pulmonary fibrosis, cystic fibrosis, sarcoidosis	Aortic aneurysm, heart failure, bacterial endocarditis	Inflammatory bowel disease, malignant tumor, infectious disease, amoebiasis, roundworm Liver disease – chronic active hepatitis, cirrhosis	AIDS, arterial transplant sepsis	Secondary thyroid disease, primary hyperthyroidism	scleroperiostosis

 

출처 및 참조 문헌 Sources and references

• NelsonTextbook of Pediatrics 22ND Ed
• The Harriet Lane Handbook 22ND Ed
• Growth and development of the children
• Red Book 32^nd Ed 2021-2024
• Neonatal Resuscitation, American Academy of Pediatrics

Copyright ⓒ 2014 John Sangwon Lee, MD., FAAP

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