Pestle finger refers to a marked widening and thickening of the terminal phalanges, with a curved bulge of the nail from the root to the end. Cough with pestle finger can be seen in bronchiectasis (bronchiectasis can be classified as congenital or secondary. Congenital is less common and is due to congenital bronchial dysplasia, the presence of congenital defects or genetic disorders. The main pathogenic factors in secondary bronchiectasis are recurrent infections of the bronchi and lungs, bronchial obstruction and involvement of the bronchi, with the three factors interacting with each other…) , chronic abscesses. So, how is the differential diagnosis of cough with pestle finger? The following is the differential diagnosis of cough with pestle finger: 1. Chronic bronchitis: Mostly seen in middle-aged or older patients, coughing and coughing or with wheezing in winter and spring, mostly white mucus sputum, and pus sputum when there is a concurrent infection. In acute attacks there are scattered dry and wet ? The sound is different from the fixed wet sound of bronchiectasis. Unlike the fixed wet sound in bronchiectasis, the wet sound in this disease is variable. The sound is variable, and the wet sound may disappear after coughing. 2, lung abscess: there is an acute onset process, chills, high fever, when coughing up a large amount of pus sputum body temperature drops, systemic toxemia symptoms reduce. x-ray can be seen large dense inflammatory shadows, there are cavities and fluid planes, the acute phase after effective antibiotic treatment, can be completely subside. Chronic lung abscess with previous history of acute lung abscess can often be complicated by bronchiectasis, and bronchiectasis can also be complicated by lung abscess, and the definite diagnosis depends on bronchial iodine oil imaging or HRCT. 3, pulmonary tuberculosis: there are mostly symptoms of tuberculosis toxicity such as low fever, night sweats, generalized weakness and wasting, accompanied by cough, sputum and hemoptysis, and the amount of sputum is usually small. The sound is usually located at the tip of the lung, and the chest X-ray is mostly a patchy infiltrative shadow in the upper part of the lung, and Mycobacterium tuberculosis can be found in the sputum or positive for Mycobacterium tuberculosis DNA by PCK method. 4, congenital pulmonary cysts: mostly cough, sputum and hemoptysis after secondary infection, and the chest film shows multiple well-defined round shadows with thin walls and no infiltration of the surrounding lung tissue after the disease is controlled. 5. Cough with pestle finger: The course of bronchiectasis is mostly chronic and can occur at any age. The onset of the disease can often be traced to a history of measles, pertussis or post-influenza pneumonia in early childhood, or a history of tuberculosis, endobronchial tuberculosis, or pulmonary fibrosis. Symptoms may not appear until several years later. Typical symptoms are chronic cough, coughing up large amounts of pus sputum and recurrent hemoptysis. Coughing is most frequent in the morning, evening and at bedtime, up to 100-400 ml per day, and many patients have little or no coughing at other times. Patients feel relaxed when coughing up sputum; if sputum is not drained smoothly, they feel tightness in the chest and systemic symptoms are significantly aggravated. The sputum is mostly yellow-green and pus-like, and can be foul-smelling when combined with anaerobic bacterial infections. 90% of patients often have hemoptysis of varying degrees, and the amount of hemoptysis does not necessarily parallel the severity of the disease and the extent of the lesion. In some patients, hemoptysis may be the first and only complaint, clinically known as dry bronchiectasis, commonly associated with tuberculous bronchiectasis, with lesions mostly in the upper lobe bronchi. In case of recurrent secondary infections, systemic toxemia symptoms may appear, and the patient sometimes has fever, night sweats, malaise, loss of appetite, and wasting. When bronchiectasis is complicated by compensatory or obstructive emphysema, the patient may have dyspnea, shortness of breath or cyanosis, and in advanced stages, pulmonary heart disease and cardiopulmonary failure may appear. Signs of bronchiectasis are not characteristic, but persistent fixed wet? sound may indicate bronchiectasis, and concomitant emphysema and pulmonary heart disease may have corresponding signs. Some patients (1/3) may have pestle-like fingers (toes) and generalized malnutrition.