Causes and risk factors
The inflammation of digits can be caused by a variety of causes. The main contributing factors are the different type of spondyloarthropathies; rheumatoid arthritis, psoriatic arthritis are some of the common types. Various infections like syphilis, tuberculosis, or infection of the fat pad by bacteria are the main contributing factors. Swelling of digits is a common presentation seen in sickle cell anemia or other various blood disorders. Depending upon the causation, dactylitis have been classified into various types: sickle cell anemia dactylitis, syphilitic, sarcoid types, blistering dactylitis, spondyloarthritic dactylitis and tubercular dactylitis.
Clinical presentation:
The digitis of both upper and lower extremities can be affected. Symmetrical and bilateral affection can be seen. Swelling and tenderness along with pain which restricts the movement is the characteristic feature seen. The swelling, typically giving it a sausage shape, is seen. The affected finger is warm to touch. Swelling results in reddening of the digits too.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and the physical examination carried out by the orthopedic doctor. Other symptoms are taken into consideration along with certain investigations to elicit the underlying cause. X-ray of the affected finger along with MRI and CT scan is diagnostic. Certain other investigations can also be advised if required.
Treatment:
The swelling is self-limiting and resolves spontaneously, hence no medical intervention may be needed. However, treating the underlying cause is must. In cases of infection, appropriate antibiotics and other medications are started. Where the swelling is caused due to a certain bone or joint affection, nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, DMARDS (disease modifying anti-rheumatic drugs) and pain relieving drugs are prescribed. In severe cases, corticosteroid injections and topical pain relieving gels and lubricants are advised. Hot and cold compression can be used to reduce swelling. No surgical intervention is needed.
Other modes of treatment:
Acupuncture, which is the science of insertion of fine needles on the certain stimulating spots on the body has proved to be effective. Certain yoga exercises can also be helpful in relieving the pain and strengthening the muscles.
Complications:
Although rare, sometime dactylitis can lead to shortening of fingers.
When to contact a doctor:
Recommendation of an expert in the field of orthopedics is advised in cases if one notices swelling or change in shape of digits.
System involved: Musculoskeletal system
Organ involved: bones, carpal bones, tarsal bones.
