Early manifestations of Pestle Finger may only be soft tissue swelling and degeneration at the base of the nail, often accompanied by localized soreness and thickening of the nail. Pestle Finger is usually chronic in onset and persistent. Pestle finger is a “pestle-like” enlargement of the end of the finger, which can be caused by a variety of cardiovascular, respiratory, and liver diseases. In the early stages, it is characterized by swelling and degeneration of the soft tissues at the base of the finger, similar to the shape of a transparent cap on a watch, also known as epimedial pestle finger; the swelling of the finger may be accompanied by a feeling of soreness and thickening of the nails. As the disease progresses, the symptoms may continue to worsen, with the entire end of the finger becoming visibly enlarged, and the finger resembling a “small drumstick”. Usually the skin of the terminal phalanx of the pestle finger is smooth, shiny, and the fine lines are reduced or disappear; pressure on the swollen area may cause it to sink. It is recommended that people with similar changes in their fingers seek prompt medical attention to identify the cause of the problem and then treat it aggressively.