The main features are inflammation, pain, and swelling of the fingers, toes, hands, and/or feet. As a result, the digits are often referred to as "sausage fingers." Fever is also common. Furthermore, the overall clinical picture will reflect the underlying disease.
Sickle-cell dactylitis affects young children and is self-limiting. Moreover, this type is associated with shortening of the digits which is also observed in tuberculosis dactylitis, syphilitic dactylitis and other pathologies  .
There is also another form referred to as blistering distal dactylitis. This describes a superficial infection of the anterior fat pad of the distal portion of a finger, which occurs predominantly in the pediatric population . The organism responsible for this are group A beta-hemolytic streptococci.
Jaw & Teeth
Herein, we present a three-year-old girl, who was previously vaccinated against mumps infection, admitted with bilateral parotid swelling, dactylitis and serum immunoglobulin M positivity for mumps infection and diagnosed to have ALL with bilateral persistent [medical-dictionary.thefreedictionary.com]
Face, Head & Neck
Herein, we discuss new exciting findings in animal models with enthesitis and dactylitis, summarize developments in clinical and imaging assessments and review recent clinical trial data on the efficacy of targeted therapies for enthesitis and dactylitis [ncbi.nlm.nih.gov]
While individually each category is fun to think about, the excitement more than doubles when they occur concurrently (perhaps I am being facetious). Let’s review Blistering Distal Dactylics ! [pedemmorsels.com]
[…] regurgitation, conduction defects Aortic regurgitation Pulmonary features Upper lobe fibrosis None None None Gastrointestinal conditions None Diarrhea None Crohn’s disease, ulcerative colitis Renal conditions Amyloidosis, IgA nephropathy Amyloidosis Amyloidosis Nephrolithiasis [aafp.org]
Since there are numerous etiologies for dactylitis, the patient should be evaluated for them. The assessment consists of the history, detailed physical exam, and testing for the underlying disease. Radiography is the initial diagnostic study of choice while computed tomography (CT) and magnetic resonance imaging (MRI) are useful modalities for the exclusion of differential diagnoses .
Therapy aims to treat the underlying disease. In cases of psoriatic arthritis , nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first-line treatment. According to the European League Against Rheumatism (EULAR), when NSAIDS and/or glucocorticoid injections are ineffective, then disease-modifying antirheumatic drugs (DMARDs) should be considered . Examples include tumor necrosis factor (TNF)-alpha inhibitors such as infliximab and targeted biologic therapies. Various classes of drugs can be used in conjunction with each other as well.
Physical and occupational therapy may benefit patients, especially if the disease is disabling.
There is no method for prevention.
Dactylitis is an inflammatory disease which causes pain and swelling of the finger(s) and toe(s), which look like sausage fingers. There are many causes such as sickle-cell anemia, psoriatic arthritis, and others. It is diagnosed by history, physical exam, blood tests and imaging. The treatment depends on the cause.
- Olivieri I, Scarano E, Padula A, Giasi V, Priolo F. Dactylitis, a term for different digit diseases. Scandinavian Journal of Rheumatology. 2006;35(5):333-40.
- Ritz N, Connell TG, Tebruegge M, Johnstone BR, Curtis N. Tuberculous dactylitis--an easily missed diagnosis. European Journal of Clinical Microbiology and Infectious Diseases. 2011;30(11):1303-10.
- Helliwell PS, Firth J, Ibrahim GH, Melsom RD, Shah I, Turner DE. Development of an assessment tool for dactylitis in patients with psoriatic arthritis. The Journal of Rheumatology. 2005;32(9):1745–1750.
- Olivieri I, Barozzi L, Favaro L, et al. Dactylitis in patients with seronegative spondylarthropathy. Assessment by ultrasonography and magnetic resonance imaging. Arthritis and Rheumtism 1996;39(9):1524–8.
- Coates LC, Helliwell PS. Disease measurement--enthesitis, skin, nails, spine and dactylitis. Best PractIce and Resarch. Clinical Rheumatology. 2010;24(5):659-70.
- Haddad A, Johnson SR, Somaily M, et al. Psoriatic Arthritis Mutilans: Clinical and Radiographic Criteria. A Systematic Review. Journal of Rheumatology. 2015;42(8):1432-8.
- Maruschke L, Baumann T, Zajonc H, Herget G. Monostotic fibrous dysplasia of the middle phalanx of the hand. Journal of Medical Cases. 2013;4(5):318–322.
- Hassan FOA. Tuberculous dactylitis pseudotumor of an adult thumb: a case report. Strategies in Trauma and Limb Reconstruction. 2010;5(1):53–56.
- Fretzayas A, Moustaki M, Tsagris V, Brozou T, Nicolaidou P. MRSA blistering distal dactylitis and review of reported cases. Pediatric Dermatology. 2011;28(4):433-5.
- Bakewell CJ, Olivieri I, Aydin SZ, et al. OMERACT Ultrasound Task Force. Ultrasound and magnetic resonance imaging in the evaluation of psoriatic dactylitis: status and perspectives. Journal of Rheumatology. 2013;40(12):1951-7.
- Gossec L, Smolen JS, Gaujoux-Viala C, et al. European League Against Rheumatism recommendations for the management of psoriatic arthritis with pharmacological therapies. Annals of Rheumatic Disease. 2012;71(1):4-12.