Question

In which one of the following conditions can dactylitis NOT be seen?

• A. Sickle-cell anemia
• B. Beta thalassemia
• C. Congenital syphilis
• D. Tuberculosis

Hint:

Think of hand-foot syndrome and which disease mainly affects the skull and long bones instead of the digits.

Answer 1

The Correct Option is B

Dactylitis is painful swelling of a finger or toe, caused by inflammation or bone changes in that digit. The question asks which of four conditions does not cause this.

1. Sickle-cell anemia: Causes hand-foot syndrome, where sickled cells block tiny vessels in the bones of the hands and feet, leading to painful swelling. This is a well known early sign in affected infants and toddlers.
2. Beta thalassemia: Leads to marrow expansion and skull or facial bone changes from chronic anemia, but it does not produce swelling of individual fingers or toes. Dactylitis is not part of its typical picture.
3. Congenital syphilis: Can inflame the periosteum of the small bones of the hands, giving a form of dactylitis with symmetrical finger swelling.
4. Tuberculosis: Can infect small hand bones and produce a cystic, swollen digit known as tuberculous dactylitis or spina ventosa.

Three of the four conditions, sickle-cell anemia, congenital syphilis, and tuberculosis, are linked to dactylitis. Beta thalassemia is the one that is not.

Let's summarize:

• Dactylitis means painful digit swelling from bone or soft tissue involvement.
• Sickle-cell disease, congenital syphilis, and tuberculosis are all known causes.
• Beta thalassemia affects the marrow and skull, not individual digits.

So the answer is beta thalassemia.