The microanatomic basis of finger clubbing - a high-resolution magnetic resonance imaging study
Junichi Nakamura1, Nicola Ann Halliday, Eiji Fukuba
1From the UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Radiology, Faculty of Medicine, Shimane University, Shimane, Japan; Medical Physics and Engineering, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds, UK.
Objective:
Hypervascularization in finger clubbing is recognized, but its microanatomical basis remains unclear. This pilot descriptive study used magnetic resonance imaging (MRI) to explore this further.
Methods:
High-resolution MRI acquired with contrast agent was carried out in 4 patients with finger clubbing and 4 healthy volunteers. The anatomy of the nail bed, capsular structures, and bony changes were described.
Results:
Marked nail bed thickening and contrast enhancement was noted in all clubbed fingers, with bone edema in 3 of the 4 patients. None of the healthy subjects had similar abnormalities.
Conclusion:
This confirms that hypervascularization of the nail bed observed in the microanatomy on high-resolution MRI is associated with clubbed appearances of the nails.
Insights
High-resolution MRI reveals that nail bed thickening and increased blood supply are key microanatomical features of finger clubbing. This study confirms hypervascularization as a significant factor in the development of clubbed nails.
Area of Science:
- Medical Imaging
- Anatomy
- Pathology
Background:
- Finger clubbing is a clinical sign associated with various underlying diseases.
- Hypervascularization of the digits is a known feature of finger clubbing.
- The precise microanatomical basis of this hypervascularization remains incompletely understood.
Purpose of the Study:
- To investigate the microanatomical basis of hypervascularization in finger clubbing.
- To explore the role of magnetic resonance imaging (MRI) in visualizing these changes.
- To correlate imaging findings with the clinical presentation of finger clubbing.
Main Methods:
- Pilot descriptive study utilizing high-resolution MRI with contrast enhancement.
- Inclusion of 4 patients diagnosed with finger clubbing and 4 healthy volunteers as controls.
- Detailed anatomical description of the nail bed, capsular structures, and bony changes.
Main Results:
- All patients with finger clubbing exhibited significant nail bed thickening and contrast enhancement.
- Bone edema was observed in 3 out of 4 patients with finger clubbing.
- No similar abnormalities were detected in the healthy control group.
Conclusions:
- High-resolution MRI confirms hypervascularization of the nail bed in finger clubbing.
- These microanatomical findings on MRI are directly associated with the characteristic clubbed appearance of the nails.
- MRI provides valuable insights into the pathophysiology of finger clubbing.
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