Uploaded August 2026 | Updated September 2026, 1 week ago
A 46-year-old man with chronic kidney disease presented with a 2-year history of painless shortening and rounding of the fingertips. Ten years earlier, he had received a diagnosis of chronic kidney disease due to obstructive nephropathy from nephrolithiasis. Since then, he had been intermittently lost to follow-up. On physical examination, all the fingertips were short, broad, and bulbous, with a pseudoclubbing appearance. The toes had similar but less severe changes. What do the findings on the exam and imaging represent? Submit your answer at NEJM.org.
#nejm
A 46-year-old man with chronic kidney disease presented with a 2-year history of painless shortening and rounding of the fingertips. Ten years earlier, he had received a diagnosis of chronic kidney disease due to obstructive nephropathy from nephrolithiasis. Since then, he had been intermittently lost to follow-up. On physical examination, all the fingertips were short, broad, and bulbous, with a pseudoclubbing appearance. The toes had similar but less severe changes. What do the findings on the exam and imaging represent? Submit your answer at NEJM.org.
#nejm
