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Tuberculous dactylitis

Case contributed by Mark Holland
Diagnosis almost certain

Presentation

Immigrant with contact with TB 2 years prior to increasing swelling of the middle finger

Patient Data

Gender: Male
x-ray

Poorly defined lytic change with medullary expansion, cortical erosion and mild periosteal reaction in the mid and distal aspect of the right middle finger in a patient with TB dactylitis.

Case Discussion

Unusual case of tuberculous dactylitis in an adult. Spread to the bone occurs via the lymphohaematogenous route but becomes symptomatic within 1–3 years after the initial.

85% of cases occur in children younger than 6 years of age. Its incidence among children with TB is 0.65–6.9%. It is more frequent in male adult patients (M:F = 3:1)

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