Tuberculous Dactylitis: An Uncommon Presentation of a Common Infection

Rao, G Nayantara; Gali, Jayasri Helen; Rao, Shanti

doi:10.1155/2016/4013471

Cited by 3 publications

(4 citation statements)

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“…In our case, along with medullary expansion, the presence of a large painful soft tissue mass was a prominent clinical feature. In reported cases of TB dactylitis, soft tissue masses are seen but are usually painless and can be accompanied by draining sinuses [7][8][9][10]. The radiographic findings and the MR images in our case showed bone expansion and a large soft tissue mass, felt to be consistent with a primary bone tumour such as high-grade chondrosarcoma.…”

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confidence: 46%

Question: A 62-year-old lady with painful swelling of right hand index finger for the last 8 weeks

2020

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supporting

confidence: 46%

Question: A 62-year-old lady with painful swelling of right hand index finger for the last 8 weeks

2020

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“…In our case, OO caused pain and swelling of distal finger phalanx that extended beyond the borders of the osseous structures, giving an appearance of a “sausage digit”, commonly referred as dactylitis. This finding is not very common in children, and when tuberculosis, infection or sickle cell crisis are excluded in majority of cases dactylitis is associated with juvenile spondyloarthritis [27–29].…”

Section: Discussionmentioning

confidence: 99%

Unusual localization and presentation of osteoid osteoma mimicking juvenile spondyloarthritis: a case report

Vlaić

Lamot

Šimunić

et al. 2019

BMC Musculoskelet Disord

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BackgroundOsteoid osteoma is a painful benign skeletal tumour of unknown aetiology. Most often it occurs in the long bones of extremities and responds well to nonsteroidal anti-inflammatory medications. However, unusual localization and atypical presentation of this tumour might present a diagnostic challenge, especially if symptoms mimic that indicative of juvenile spondyloarthritis.Case presentationA misdiagnosed ten-and-a-half-year-old girl with osteoid osteoma involving the distal phalanx of a little finger is presented. Her initial symptoms were pain and swelling of the little finger resembling dactylitis, while various imaging modalities showed signs of tenosynovitis, indicating a possible development of juvenile spondyloarthritis. Several trials of different non-steroid anti-inflammatory drugs gave no satisfactory results and ultrasound guided triamcinolone-hexacetonide injection provided only a short relief. Finally, almost three years after initial presentation, persistent clinical symptoms warranted repeated imaging that raised suspicion of an osteoid osteoma. Directed treatment with surgical intervention led to almost immediate and complete resolution of her symptoms.ConclusionsOsteoid osteoma should be suspected in case of a tender swelling of a digit in children and adolescents, regardless of initial imaging findings and clinical presentation. Early diagnosis and treatment of this benign condition can have a substantial impact on quality of life of patients and their families and protect them from many unnecessary diagnostic procedures and treatment.Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2383-1) contains supplementary material, which is available to authorized users.

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“…There is potential for preservation of good hand function when the diagnosis is made early as Mycobacterium tuberculosis does not produce proteolytic enzymes that can destroy the cartilage [9] . Even in an endemic country like India where tuberculosis is common, this diagnosis is missed or often delayed, particularly due to usual absence of stigmata of pulmonary tuberculosis resulting in potentially fatal consequences [10] . There are various conditions that can mimic tuberculosis dactylitis, like benign and malignant tumours, endocrinopathies, metabolic disorders, sickle cell dactylitis, non-infectious granulomatous disease, fungal and pyogenic osteomyelitis, Brodie's abscess, syphilitic dactylitis, brucellosis and actinomycosis [11,12] .…”

Section: Discussionmentioning

confidence: 99%

“…There are various conditions that can mimic tuberculosis dactylitis, like benign and malignant tumours, endocrinopathies, metabolic disorders, sickle cell dactylitis, non-infectious granulomatous disease, fungal and pyogenic osteomyelitis, Brodie's abscess, syphilitic dactylitis, brucellosis and actinomycosis [11,12] . Thus, one should be vigilant while dealing with the pathology of short tubular bones of feet and hands [10] . Any delay in diagnosis and treatment of tuberculosis dactylitis is likely to decrease the chances of good functional outcome [13] .…”

Section: Discussionmentioning

confidence: 99%

Tuberculous dactylitis (Spina ventosa) of proximal phalanx in a 10-year-old girl: A case report

Kumar¹,

Sp²,

Mannual³

2020

Int. J. Orthop. Sci.

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Tubercular dactylitis, defined as Tubercular osteomyelitis of the short tubular bones of the hand and feet is an uncommon condition seen predominantly in children. The condition is characterised by cystic expansion of the bone due to filling up of the medullary canal with granulation tissue and pus and thinning of the overlying cortex, a condition radiologically termed as 'spina ventosa'. We report a case of a 10-year-old girl who presented with a painful, slowly progressive swelling of two months' duration in the index finger of right hand, without any associated history of trauma. The plain radiographs of the hand showed extensive destruction of the proximal phalanx of index finger with thinning of the overlying cortex. Magnetic Resonance Imaging (MRI) showed diffuse enlargement and focal cortical break in the proximal phalanx with thick organised fluid in the medullary canal with a small area of cortical breech. The finger was debrided and the digit stabilised by a K-wire which was removed at three weeks. Biopsy of the debrided material confirmed the clinical diagnosis of Tubercular osteomyelitis. The child was started on anti-tubercular drugs with aggressive mobilisation of the finger at three weeks. At one-year follow-up, the lesion had healed well with functional range of movements of the right index finger.

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Tuberculous Dactylitis: An Uncommon Presentation of a Common Infection

Cited by 3 publications

References 5 publications

Question: A 62-year-old lady with painful swelling of right hand index finger for the last 8 weeks

Question: A 62-year-old lady with painful swelling of right hand index finger for the last 8 weeks

Unusual localization and presentation of osteoid osteoma mimicking juvenile spondyloarthritis: a case report

Tuberculous dactylitis (Spina ventosa) of proximal phalanx in a 10-year-old girl: A case report

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