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  Global Journal of Surgery. Volume 2, Issue 1 (2011) pp. 54-56
  Research Article
Tubercular Dactylitis: A diagnostic Challenge but a therapeutic reward
  B HariKrishnan, Amit Kumar Shah*, Samir Agarwal, DK Khare  
Department of Orthopaedics, 158 Base Hospital, PIN 900326, C/o 99 APO, India
  Tuberculous dactylitis (TD) is a rare disorder. Because of the subtle nature of the symptoms, the diagnosis is not made until the process is well advanced. Bone pain which does not promptly respond to analgesic medication is often due to infection or neoplasia. On plain radiographs, more advanced lesions may mimic chronic pyogenic osteomyelitis, Brodie’s abscess, tumours or granulomatous lesions. Biopsy is mandatory to confirm the diagnosis, and antituberculous treatment (ATT) is the mainstay of treatment. Here we report a case of TD involving first metacarpal of right hand and first metatarsal of left foot in a 04 year old child who had no other focus of tuberculosis. Her elder sibling was on ATT for pulmonary tuberculosis. This disease is the source of a diagnostic hardship as it is difficult to distinguish from other lesions. Hence, this rare manifestation of extra-pulmonary tuberculosis must be kept in mind in the diagnosis of a slowly-growing bone tumour for the best functional outcome.
  Tuberculosis; Tubercular Dactylitis; Bony Tuberculosis; Osteitis Tuberculosa Multiplex Cystica; Spina ventosa; Cystic bony lesion  

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