Dactylitis

Author: Vanessa Ngan, Staff Writer, 2007. Updated by Dr Douglas White, Rheumatologist, Hamilton, New Zealand, November 2017.

What is dactylitis?

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?

Dactylitis is a feature of the conditions listed below.

Infection        

Blistering distal dactylitis    

Tuberculous dactylitis         

Syphilitic dactylitis   

Spondyloarthritis     

Gout               

Sarcoidosis    

Sickle-cell dactylitis

Importantly, dactylitis is not considered a typical feature of rheumatoid arthritis or osteoarthritis. 

What are clinical features of dactylitis?

In adults, dactylitis is frequently part of a systemic inflammatory condition. Other joints and areas may therefore be affected. The inflamed digit is usually swollen and painful with consequently reduced function.

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.

Treatment of dactylitis

Dactylitis caused from infectious agents can be treated with appropriate antibiotics

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. This may involve immunosuppressive medications,  or in gout, treatment to reduce serum uric acid. Non-steroidal anti-inflammatory medications and local injections of corticosteroid may help with symptom control.

Related information

Email Newsletter

Would you like to receive our dermatology updates by email?

SIGN UP

Submit your images

We're seeking high-quality photos of skin diseases.  

SUBMIT A PHOTO

Machine diagnosis

Watch DermNet's proposal to create a 'Skin Disease Image Recognition Tool' - winner of the 2017 'Clinicians' Challenge Active Award' by the NZ Ministry of Health and HiNZ.

Subscribe to our mailing list

* indicates required
DermNet NZ Newsletter