Idiopathic Clubbing

To the Editor: With respect to the Image in Clinical Medicine entitled “Idiopathic Clubbing” (Oct. 26 issue), 1 it seems difficult to justify the use of right heart catheterization, a technique with a recognized risk of complications and even of death, 2 in the investigation of an asymptomatic clinical finding that had been unchanged for the better part of four decades. It may be that the clinicians did have a good reason to proceed with this investigation, but if so, it was not stated. Dr. Reynen and a colleague reply: To the Editor: Boyd et al. 1 reported a substantial risk of complications . . .