Digital hippocratism is a deformation of the fingers of the hand, and sometimes of the toes. It can be the consequence of different diseases. Treatment for digital hippocratism requires identifying and treating the underlying disease.

Digital hippocratism refers to a finger deformity which was first described by the Greek physician Hippocrates. This symptom is characterized by:

• enlargement of the fingertips, with the nails taking a convex or convex shape;
• enlarged tissue at the fingertips, that is, an increase in the volume of the soft tissues of the pulp of the fingers;
• increased heat in the fingers.

In medical jargon, digital hippocratism is sometimes defined as the appearance of “drumstick fingers” because the fingertips may resemble the enlarged end of drumsticks.

The mechanisms involved in the onset of digital hippocratism are not yet fully understood. According to current scientific data, this deformation of the fingers is caused by a lack of oxygenation due to a change in blood flow.

Researchers have also shown that digital hippocratism can be the result of different diseases. These include in particular respiratory, cardiovascular and digestive diseases. In some cases, these pathologies can be hereditary. We sometimes speak of family digital hippocratism. In other cases, this symptom is said to be idiopathic when the cause of the deformity is unknown.

Digital hippocratism: the causes of respiratory origin

Digital hippocratism has been found in lung disease such as:

• un lung cancer primary or secondary;
• a pneumopathy severe infiltrating, severe lung disease;
• lymphoid interstitial lung disease, a lung disease which occurs in particular during acquired immunodeficiency syndrome (AIDS);
• a TB, an infectious disease that affects the lungs;
• severe bronchopulmonary dysplasia, chronic respiratory disease;
• a cystic fibrosis, a rare genetic disease of the respiratory tract;
• a bronchiolitis obliterans, a disease that affects the bronchioles, essential structures of the respiratory system;
• primary ciliary dyskinesia, a rare respiratory disease.

Digital hippocratism: the causes of cardiovascular origin

The origin of digital hippocratism is sometimes located at the level of the cardiovascular system. This symptom can especially occur when:

• cyanogenic congenital heart disease, a malformation of the cardiovascular system;
• infectious endocarditis, cardiovascular disease which results in inflammation of the inner layer of the heart;
• an fistula pulmonary arteriovenous, an abnormality characterized by abnormal communication between a pulmonary artery and a pulmonary vein.

Digital hippocratism: the causes of digestive origin

Digital hippocratism can also be the result of a disease affecting the digestive tract, especially in cases of:

• chronic inflammatory bowel disease (IBD) such as Crohn’s disease and ulcerative colitis;
• chronic active hepatitis, an inflammatory liver disease;
• an hepatic cirrhosis, chronic liver disease;
• primary biliary cirrhosis, liver disease that affects the bile ducts;
• achalasia of the esophagus, a disorder affecting the motor skills of the esophagus;
• an esophageal cancer.

Digital hippocratism: other possible causes

More rarely, digital hippocratism has been observed in certain cases:

• de thyroid cancers ;
• of thymus cancers ;
• de Hodgkin lymphoma, cancers affecting the lymphatic system;
• of thalassemia, genetic abnormalities.

Depending on the case, digital hippocratism is more or less pronounced. It usually affects all the fingers of the hand. As it progresses, it can affect the toes. In this case, digital hippocratism can also be accompanied by joint pain.

Digital hippocratism is usually diagnosed by simple physical examination. However, in the beginner forms, this symptom can be more difficult to identify. Additional clinical examinations can be performed. In particular, the thickness of the last phalanges and certain angles of the fingers can be measured to confirm the diagnosis.

Treatment for digital hippocratism involves treating the cause of the deformity. Adequate medical treatment usually allows the fingers to return to their normal appearance.