71-year old man complained of enlargement of his distal phalanges. He
did not have any other musculoskeletal complaints, and he denied
pulmonary symptoms. He was a heavy smoker. Medical history was
unremarkable. He did not have symptoms of cardiac or liver disease.
Physical examination showed obvious clubbing of his fingers. Chest
examination revealed dullness to percussion and decreased air entry at
the right base. There was no lymphadenopathy. Results of cardiac
examination were normal. The liver was not enlarged.