Tuberculosis Dactylitis in a Patient With Rheumatoid Arthritis: A Case Report

Tuberculosis (TB) dactylitis of the hand is a rare and challenging pathology, requiring positive bacterial identification through culture or biopsy for diagnosis. Treatment is also challenging, although it typically yields an excellent response to long-term tuberculostatic therapy. We describe a case of osteoarticular tuberculous dactylitis in a 36-year-old woman with rheumatoid arthritis (RA) and a history of lymphoma. The suspicion arose from an insidious, painless swelling of the proximal interphalangeal joint of the second digit of the right hand in a patient undergoing methotrexate treatment for RA. Under a long-term anti-TB multi-drug regimen, the patient's signs and symptoms progressively improved, and hand function was nearly fully restored. The authors discuss the diagnostic and surgical treatment challenges encountered in plastic and reconstructive surgery care.