Dactylitis is inflammation of a digit (either finger or toe) and is derived from the Greek word dactylos meaning finger. The affected fingers and/or toes swell up into a sausage shape and can become painful.
What causes dactylitis?
Although any inflammatory process involving the fingers or toes may be called dactylitis, the term has been used to describe some well defined disease entities where swelling of the digits is an obvious symptom.
Type of dactylitis
Sickle-cell dactylitis (also known as hand-foot syndrome)
Occurs in patients with sickle-cell anaemia, most frequently for the first time within the first 4 years of life
In many cases dactylitis is the first sign of the presence of the blood disorder and often leads to the diagnosis of sickle-cell disease
Sickle-cell dactylitis is often mistaken for other diseases, especially acute osteomyelitis, cellulitis, leukaemia, and rheumatic fever
Similar features as tuberculous dactylitis but involvement is bilateral and symmetrical
Occurs in about 0.2% of patients with sarcoidosis, and often associated with lupus pernio (large bluish-red and dusky purple infiltrated nodules and plaque-like lesions on nose, cheeks, ears, fingers and toes)
Bone and soft tissue involvement of the fingers that classically presents as bilateral, fusiform or sausage-shaped swellings
Blistering distal dactylitis
A superficial infection of the anterior fat pad of the distal portion of the finger(s), most often occurring in children
In children with sickle-cell disease, the first sign is usually quite sudden and is characterised by painful swelling of the hands, feet, or both. The child refuses to bear weight and has puffy, tender and warm fingers and/or toes. This is often accompanied by fever, raised white cell count and mild anaemia.
The clinical symptoms in sickle-cell dactylitis are self-limiting. Swelling and pain usually subsides spontaneously without any medical or surgical treatment. The duration of symptoms may range from several days to a month. It rarely causes permanent damage but in some cases may result in shortening of the fingers as a result of premature fusion of the epiphyseal plates.
In other types of dactylitis, treating the cause is the main form of therapy. Dactylitis caused from infectious agents can be treated with appropriate antibiotics.
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