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Dactylitis, a term for different digit diseases.

I Olivieri1, E Scarano, A Padula

  • 1Rheumatology Department of Lucania, San Carlo Hospital of Potenza, Potenza, Italy. ignazioolivieri@tiscalinet.it

Scandinavian Journal of Rheumatology
|October 26, 2006
PubMed
Summary
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Dactylitis, inflammation of fingers or toes, encompasses various conditions like tuberculous, syphilitic, and sarcoid forms. Recent imaging reveals flexor tenosynovitis as the cause of sausage-like digits in spondyloarthritis.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Radiology

Background:

  • Dactylitis, defined as inflammation of a finger or toe, presents in several distinct clinical entities.
  • These conditions vary in the specific tissues affected within the digit and the nature of the inflammation.

Purpose of the Study:

  • To differentiate various forms of dactylitis based on their underlying causes and radiological presentations.
  • To elucidate the pathophysiology of dactylitis, particularly in spondyloarthritis, using advanced imaging techniques.

Main Methods:

  • Review of clinical definitions and radiological characteristics of different dactylitis types, including tuberculous, syphilitic, sarcoid, blistering distal, sickle cell, and spondyloarthritis dactylitis.
  • Analysis of recent ultrasonography (US) and magnetic resonance imaging (MRI) studies investigating the 'sausage-like' digit in spondyloarthritis.

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Main Results:

  • Tuberculous dactylitis shows spina ventosa on radiographs; syphilitic dactylitis is bilateral and symmetric.
  • Sarcoid dactylitis involves granulomas in phalanges and soft tissues; blistering distal dactylitis is a streptococcal infection.
  • Sickle cell dactylitis results from bone marrow infarction; spondyloarthritis dactylitis is characterized by flexor tenosynovitis, not necessarily joint capsule enlargement or enthesitis.

Conclusions:

  • Dactylitis encompasses a spectrum of inflammatory conditions affecting digits, each with unique etiologies and imaging findings.
  • Advanced imaging confirms flexor tenosynovitis as the primary cause of the characteristic swelling in spondyloarthritis dactylitis.