Hand-foot syndrome, also simply referred to as dactylitis, is a self-limiting manifestation of a vaso-occlusive crisis in individuals with sickle cell anemia.
Dactylitis is not a specific finding in sickle cell disease, therefore cautious usage is advised if one chooses to employ it as a synonym for hand-foot syndrome.
Children from 6 months to 3 years of age are usually affected 1.
Hand-foot syndrome is usually seen in the setting of systemic symptoms of fever and elevated white cell count 1. It is characterized by swelling of the hands and feet, particularly over the dorsal aspects 1. It can be unilateral or bilateral.
Features are difficult to distinguish from infection especially if localised (e.g. salmonella) 2.
Hand-foot syndrome in sickle cell disease should not be confused with:
- 1. Vaishya R, Agarwal AK, Edomwonyi EO, Vijay V. Musculoskeletal Manifestations of Sickle Cell Disease: A Review. (2015) Cureus. 7 (10): e358. doi:10.7759/cureus.358 - Pubmed
- 2. Bennett OM. Salmonella osteomyelitis and the hand-foot syndrome in sickle cell disease. (1992) Journal of pediatric orthopedics. 12 (4): 534-8. Pubmed