An unusual presentation of tubercular dactylitis with subluxation of the metacarpo-phalangeal joint in an adult

Abstract

Introduction: Tuberculosis rarely affects the bones of the hand and feet. This entity is described as tubercular dactylitis (TB dactylitis). It affects children. TB dactylitis in an otherwise healthy adult is extremely rare.Case report: We report an extremely rare presentation of TB dactylitis is a 35 year old female patient. She presented to us with pain and swelling of her index finger since a year. A synovial biopsy was taken and diagnosis of TB dactylitis was confirmed. The patient was administered one year of Anti tubercular treatment and was disease free at the end of treatment. Conclusion: TB dactylitis is extremely rare in adults. There are reports in adults with pre-existing conditions such as HIV or other immunosuppressive conditions. It is the recommendation of the authors not to rule out Tubercular dactylitis as a differential when dealing with chronic painful swelling of fingers in adults.