title: Tuberculous Dactylitis: An Uncommon Presentation of Skeletal Tuberculosis.
abstract: BACKGROUND
  Skeletal involvement accounts 1-5% of all cases of Tuberculosis. The vertebrae are more commonly affected. The bones of the hands are more affected than the bones of the feet. The term "spina ventosa" has been used to describe this disorder because of its radiographic features of cystic expansion of the involved short tubular bones. Tuberculous dactylitis mainly occurs through lympho-hematogenous spread. The lung is the primary focus in 75% of cases.
  
  
  METHODS
  A 4 years old female child developed a painless swelling on her left index finger two months prior to her presentation. Following an unsuccessful treatment as a case of osteomyelitis with antibiotics, imaging showed an expansile lytic lesion with sclerosis, and fine needle aspiration confirmed tuberculous dactylitis. The child was initiated on anti-tubercular treatment with subsequent marked clinical and radiologic improvement.
  
  
  CONCLUSIONS
  Presence of longstanding finger swelling and pain should alert a clinician to consider active disseminated tuberculosis. Furthermore, proper interpretation of imaging and use of fine needle aspiration has been highlighted.
authors.affiliation: Department of Pediatrics and Child health, School of Medicine, Addis Ababa University, Ethiopia.
authors.forename: Workeabeba
authors.initials: W
authors.lastname: Abebe
authors.affiliation: Department of Pediatrics and Child health, School of Medicine, Addis Ababa University, Ethiopia.
authors.forename: Betel
authors.initials: B
authors.lastname: Abebe
authors.affiliation: Department of Pediatrics and Child health, School of Medicine, Addis Ababa University, Ethiopia.
authors.forename: Kebede
authors.initials: K
authors.lastname: Molla
authors.affiliation: Department of Pediatrics and Child health, School of Medicine, Addis Ababa University, Ethiopia.
authors.forename: Tinsae
authors.initials: T
authors.lastname: Alemayehu
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D001842:Bone and Bones / Q000473:pathology*; D002675:Child, Preschool; D005260:Female; D005385:Fingers / Q000473:pathology*; D006801:Humans; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D014394:Tuberculosis, Osteoarticular / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
chemical_list: D000995:Antitubercular Agents
keywords: Expansile lytic lesion; Spina ventosa; Tuberculosis; Tuberculous dactylitis