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tuberculous dactylitis; spina ventosa
Etiology:
- Mycobacterium tuberculosis
Clinical manifestations:
- pain & swelling of finger [2]
- pain & swelling on dorsum of hand over metacarpal
Laboratory:
- culture of aspirate (Mycobacterium tuberculosis culture)
Radiology:
- X-ray of hand
- slightly thinned cortex surrounding a lytic core with trabecular pieces on metacarpal bone (case report) [1]
- no periosteal reaction [1]
- chest X-ray to rule out pulmonary tuberculosis Differetial diagnosis:
- osteomyelitis
- sarcoidosis
- enchondroma
Management:
- see tuberculosis
Notes:
- case report [2] in patient with lupus on mycophenolate & prednisone with household exposure to pulmonary tuberculosis
General
dactylitis (sausage digit)
tuberculoma
References
- Baeza-Trinidad R, Oteo Revuelta JA
Spina Ventosa
N Engl J Med 2015; 372:e18. March 26, 2015
PMID: 25806937
http://www.nejm.org/doi/full/10.1056/NEJMicm1315601
- Mandal J, Margaretten M
Tuberculosis of the Finger.
N Engl J Med 2018; 379:1161
PMID: 30231233 Free full text
https://www.nejm.org/doi/full/10.1056/NEJMicm1800879