This is a great example of clubbed fingers. It is often associated with chronic pulmonary illness, cyonitic heart disease, sub-acute bacterial endocarditis or ulcerative colitis.
This patient was a 50-year old female presenting with TB-symptoms, a chest X-ray was done, showing infiltration of the upper lobes. The radiologist suggested TB. The patient was referred to the clinic where the TB doctor re-X-rayed her chest, and found it not to be a case of TB. Sputum tested negative and the patient was referred to medical out-patients at tertiary hospital.
At present she is still presenting with TB-symptoms and was exposed to an infected patient. She is a long time smoker, also suggesting chronic obstructive pulmonary disease as a possibility.
This condition was detected during occupational health medical surveillance (baseline medical examination). It is important to know the reason for her condition, to prevent a deterioration in her condition due to possible exposure at her workplace, or in case of a bacterial tuberculosis, spreading to other workers.
