Tuberculous dactylitis pseudotumor of an adult thumb: a case report

Gali

Case Reports in Pediatrics

2016

Tuberculous dactylitis is an unusual form of osteoarticular tuberculosis involving the short tubular bones of hands and feet, which is uncommon beyond six years of age. We report the case of a fifteen-year-old adolescent boy who was diagnosed with tuberculous dactylitis, involving contralateral hand and foot. His diagnosis was delayed due to lack of suspicion of this rare entity. The report also examines the diagnostic difficulties faced by clinicians in arriving at an appropriate diagnosis.

Section: Discussionmentioning

confidence: 99%

Tuberculous Dactylitis: An Uncommon Presentation of a Common Infection

Gali

Case Reports in Pediatrics

2016

“…Even in an endemic country like India where tuberculosis is common, this diagnosis is missed or often delayed, particularly due to usual absence of stigmata of pulmonary tuberculosis resulting in potentially fatal consequences [10] . There are various conditions that can mimic tuberculosis dactylitis, like benign and malignant tumours, endocrinopathies, metabolic disorders, sickle cell dactylitis, non-infectious granulomatous disease, fungal and pyogenic osteomyelitis, Brodie's abscess, syphilitic dactylitis, brucellosis and actinomycosis [11,12] . Thus, one should be vigilant while dealing with the pathology of short tubular bones of feet and hands [10] .…”

Section: Discussionmentioning

confidence: 99%

Tuberculous dactylitis (Spina ventosa) of proximal phalanx in a 10-year-old girl: A case report

Kumar¹,

Sp²,

Mannual³

2020

Int. J. Orthop. Sci.

Tubercular dactylitis, defined as Tubercular osteomyelitis of the short tubular bones of the hand and feet is an uncommon condition seen predominantly in children. The condition is characterised by cystic expansion of the bone due to filling up of the medullary canal with granulation tissue and pus and thinning of the overlying cortex, a condition radiologically termed as 'spina ventosa'. We report a case of a 10-year-old girl who presented with a painful, slowly progressive swelling of two months' duration in the index finger of right hand, without any associated history of trauma. The plain radiographs of the hand showed extensive destruction of the proximal phalanx of index finger with thinning of the overlying cortex. Magnetic Resonance Imaging (MRI) showed diffuse enlargement and focal cortical break in the proximal phalanx with thick organised fluid in the medullary canal with a small area of cortical breech. The finger was debrided and the digit stabilised by a K-wire which was removed at three weeks. Biopsy of the debrided material confirmed the clinical diagnosis of Tubercular osteomyelitis. The child was started on anti-tubercular drugs with aggressive mobilisation of the finger at three weeks. At one-year follow-up, the lesion had healed well with functional range of movements of the right index finger.

“…The final diagnosis of tuberculous arthritis is based on bacteriology and histological studies. The differential diagnosis of tuberculous arthritis includes gout, sarcoidosis, osteomyelitis and tumors[ 9 ]. Inflammatory and infective lesions may show high grade FDG uptake, and every lesion which demonstrates high SUV should not be labeled as a malignancy[ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Case of victims of modern imaging technology: Increased information noise concealing the diagnosis

Mahajan

Santhoshkumar

Kawthalkar

et al. 2017

WJR

We present a case of tubercular arthritis who underwent numerous unnecessary investigations what is known as “victims of modern imaging technology” or VOMIT. Today there is an exponential rise in the volume of the medical imaging, part of which is contributed by unnecessary and unjustified indications. We discuss about the untoward effects of the uninhibited and careless use of modern imaging modalities and possible ways to avoid. Skeletal manifestation of the tuberculosis is still common in the endemic countries like India. Although the final diagnosis of the skeletal tuberculosis like tubercular arthritis is made by bacteriological and histological studies, few demographic, clinical and radiological features might help making early diagnosis.