Tuberculous dactylitis (spina ventosa) with concomitant ipsilateral axillary scrofuloderma in an immunocompetent child: A rare presentation of skeletal tuberculosis

Tuberculosis (TB) remains a major global public health problem, with 1.5 million deaths annually worldwide. One in five cases of TB present as extrapulmonary TB (EPTB), posing major diagnostic and management challenges. Mycobacterium tuberculosis adapts to a quiescent physiological state and is notable for its complex interaction with the host, producing poorly understood disease states ranging from latent infection to active clinical disease. New tools in the diagnostic armamentarium are urgently required for the rapid diagnosis of TB and monitoring of TB treatments, and to gain new insights into pathogenesis. The typical and atypical imaging features of EPTB are reviewed herein, and the roles of several imaging modalities for the diagnosis and management of EPTB are discussed.

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“…At radiography, pronounced fusiform soft tissue swelling with or without periostitis is the most common finding. 41,42…”

Section: Tubercular Dactylitismentioning

confidence: 99%

Imaging in extrapulmonary tuberculosis

Gambhir

Ravina

Rangan

et al. 2017

International Journal of Infectious Diseases

110

101

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“…Spina Ventosa is an uncommon disease caused by tuberculosis bacteria, which causes damage to the bones and skin without a primary site of infection. 1 , 2 The long bones are frequently damaged, and there is diffuse sclerosis of the short bones in the hands and feet. Since the development of the epiphyseal centers, Spina Ventosa rarely occurs after the age of 6.…”

Section: Introductionmentioning

confidence: 99%

Late Discovering Spina Ventosa: A Case Report

Ngoc¹,

Thai²,

Van³

et al. 2021

IMCRJ

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Introduction: Spina Ventosa is a rare condition that is easy to misdiagnose as other diseases. We present a case of late-diagnosed Spina Ventosa, which had not only the osteoarticular tuberculosis symptoms but also some severe symptoms, including pleural effusion, ascites, and anemia. By intensive treatment, our patient recovered completely. Case Report: A 7-year-old boy was admitted with complaints of painless swelling of metacarpals, metatarsals, and phalanges of his hands and feet and a discharging sinus of the left toe. There was no family or past history of tuberculosis. His immunizations were up to date. General examination revealed that the child had pallor and was emaciated. No lymphadenopathy was detected. Investigations revealed hemoglobin: 74 g/l, and erythrocyte sedimentation rate (ESR) was 42 mm/hour. QuantiFERON-TB test was positive. The radiograph showed irregular swelling with sclerosis of the underlying bones. The right-hand x-ray showed cortical destruction, sclerosis, and cystic expansion or right second metacarpal. Chest x-ray indicated pleural effusion. Histopathological examination of specimen from the foot and lung and abdomen fluid confirmed tuberculosis. The child was treated with the first-line tuberculosis treatment regimen (Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide) for two months, followed by Isoniazid, Rifampicin, and Pyrazinamide for a further four months. His lesions disappeared after six weeks of intensive treatment. Conclusion:A delay in diagnosis and treatment of tuberculosis can lead to systemic manifestations in multiple organs. Despite the delay in diagnosis, this child had a good outcome due to being treated promptly and adequately after the presentation.

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“…Tuberculous dactylitis is quite uncommon beyond 6 years of age after the formation of the epiphyseal centers. It often becomes symptomatic 1-3 years following the initial infection [6,7] . The bones of the hands are more affected than the bones of the feet.…”

Section: Introductionmentioning

confidence: 99%

Spina ventosa in a twelve year old boy: A case report

Temani¹,

Harshvardhan²,

Bansal³

et al. 2019

Int. J. Orthop. Sci.

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Spina Ventosa is a rare condition. The term "spina ventosa" has been used to describe tuberculous dectylitis because of its radiographic features of spindle shaped expansion of the short tubular bones due to tuberculous granuloma. Children less than 10 years of age are most frequently affected and the hand is the most commonly affected site in Tuberculous dactylitis. We report the case of a twelve-year-old adolescent boy who was diagnosed with tuberculous dactylitis, involving the proximal phalanx of middle finger of right hand. His diagnosis was delayed due to lack of suspicion of this rare entity.

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Tuberculous dactylitis (spina ventosa) with concomitant ipsilateral axillary scrofuloderma in an immunocompetent child: A rare presentation of skeletal tuberculosis

Cited by 15 publications

References 9 publications

Imaging in extrapulmonary tuberculosis

Imaging in extrapulmonary tuberculosis

Late Discovering Spina Ventosa: A Case Report

Spina ventosa in a twelve year old boy: A case report

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