Author: Vanessa Ngan, Staff Writer, 2007. Updated by Dr Douglas White, Rheumatologist, Hamilton, New Zealand, November 2017.
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.
Dactylitis is a feature of the conditions listed below.
Blistering distal dactylitis
Importantly, dactylitis is not considered a typical feature of rheumatoid arthritis or osteoarthritis.
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.
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