Tuberculous dactylitis, also known as spina ventosa, is a skeletal manifestation of tuberculosis.
Tuberculous osteitis is one of the commonest bacterial osteitis. Typically the dactylitis form affects paediatric age group more often than adults. In children multiple or consecutive bones are involved, compared to a single bone in adults 4.
Tuberculous dactylitis involves the short tubular bones of the hands and feet in children. It often follows a benign course without pyrexia and acute inflammatory signs as opposed to acute osteomyelitis.
Plain radiography is the modality of choice for evaluation and follow up.
Tends to affect the bones distal to tarsus and wrist, with the upper limb being more commonly involved. Typically the proximal phalanx of the index/middle fingers and middle/ring finger metacarpals are affected.
- involved bone shows a diaphyseal expansile lesion
- a periosteal reaction is uncommon
- healing is by sclerosis and is usually gradual
History and etymology
This condition was first described by Boyer and Nelaton.
The term spina ventosa derives from "spina" meaning "short bone" and "ventosa" meaning "expanded with air".
The differential diagnosis includes:
- 1. Hassan FO. Tuberculous dactylitis pseudotumor of an adult thumb: a case report. Strategies Trauma Limb Reconstr. 2010;5 (1): 53-6. doi:10.1007/s11751-010-0080-1 - Free text at pubmed - Pubmed citation
- 2. Singhal S, Arbarart A, et al. Indian J Tuberc 2005;52:218-219
- 3. Harisinghani MG, Mcloud TC, Shepard JA et-al. Tuberculosis from head to toe. Radiographics. 20 (2): 449-70. Radiographics (full text) - Pubmed citation
- 4. De Vuyst D, Vanhoenacker F, Gielen J et-al. Imaging features of musculoskeletal tuberculosis. Eur Radiol. 2003;13 (8): 1809-19. doi:10.1007/s00330-002-1609-6 - Pubmed citation
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