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August 1997

Picture of the Month

Author Affiliations

From the Department of Pediatrics, University of California, Los Angeles, School of Medicine, Cedar Sinai Medical Center.

Arch Pediatr Adolesc Med. 1997;151(8):851-852. doi:10.1001/archpedi.1997.02170450101018

TWO CHILDREN, both 2 years of age, were seen with indolent swelling of the fingers (Figure 1 and Figure 2). Neither child had signs or symptoms of systemic illness. The fingers were minimally tender to palpation. Figure 3 is a radiograph of the right and left hands of the child in Figure 1.

Denouement and Discussion 

Tuberculous Dactylitis  Tuberculosis the skeleton constitutes 10% to 15% of all extrapulmonary tuberculosis. Approximately 50% of the patients who have musculoskeletal tuberculosis have no pulmonary involvement.1 Tuberculous dactylitis is the most common form of skeletal tuberculosis in infants.2 Eightyfive percent of the patients with tuberculous dactylitis are younger than 6 years and 70% are younger than 2 years.3 The incidence of tuberculous dactylitis among children with tuberculosis has been reported to be in the range of 0.65% to 6.9%.4,5 The bones of the hands are more frequently affected than those