Tuberculous dactylitis, also known as spina ventosa, is a rare skeletal manifestation of tuberculosis where the short tubular bones (i.e. phalanges, metacarpals, metatarsals) are affected.
Tuberculous osteitis is one of the commonest bacterial osteitides. Typically the dactylitis form affects children 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, in contradistinction to acute osteomyelitis.
Plain radiography is the modality of choice for evaluation and follow-up. The bones distal to the tarsus and wrist tend to be affected, with the upper limb being more commonly involved. Typically the proximal phalanx of the index/middle fingers and middle/ring finger metacarpals are affected. Characteristic features include:
- involved bone shows a diaphyseal expansile lesion
- periosteal reaction is uncommon
- healing is by sclerosis, which is usually gradual
History and etymology
Boyer and Nelaton first described this condition.
The term spina ventosa derives from "spina" meaning "short bone" and "ventosa" meaning "expanded with air".
The differential diagnosis includes:
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