| 词条 | Tuberculous dactylitis |
| 释义 |
| name = Tuberculous dactylitis | synonyms = | image = | caption = | pronounce = | field = infectious disease | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} Tuberculous dactylitis is a skeletal manifestation of tuberculosis, one of the commonest bacterial osteitis. It affects children more often than adults.[1] The first radiological description of the condition is credited to Feilchenfeld in 1896; however, the first histological description was given by Rankin in 1886.[2] The Swedish botanist and fysician Carl von Linne was the first to mention the condition by the name "spina ventosa" 1746 in his "Västgöta resa" [3]. Multiple bones are involved in children and usually only a single bone is involved in adults suffering from tuberculous dactylitis.[1] Tuberculous dactylitis affects the short tubular bones of the hands and feet in children. It often follows a mild course without fever and acute inflammatory signs as opposed to acute osteomyelitis. There may be a gap of a few months to 2 to 3 years from the time of initial infection to the point of diagnosis.[4][5][6] Spina ventosa is the term given for tuberculous dactylitis.[7] Nearly 85% of the patients of spina ventosa are below 6 years of age.The bones of hands are more commonly involved than those of the feet. Proximal phalanx of the index and middle fingers are the commonest sites of involvement.Up to nearly 7% of children with pulmonary tuberculosis may develop this condition.[8] Spread to the skeletal system is believed to occur via blood and lymphatics.[9] PathogenesisIn the pediatric age group, the marrow in the phalangeal bones are still active, a conducive place for the tuberculous bacilli to multiply. Slowly, the whole marrow space gets involved and this underlying granulomatous disease leads to expansion of the overlying soft cortex. Finally there is a fusiform dilation of the bone, with thinned out cortex and destruction of the marrow space leading to a balloon like shape; this cystic type of expansion of the bone is termed as spina ventosa.[10] DiagnosisThe diagnosis of the condition is made on the basis of histological and bacteriological studies. Tuberculosis dactylitis may be confused with conditions like osteomyelitis, gout, sarcoidosis and tumors.[11][12] References1. ^1 {{cite journal|doi=10.1007/s00330-002-1609-6|pmid=12942283|title=Imaging features of musculoskeletal tuberculosis|journal=European Radiology|volume=13|issue=8|pages=1809–19|year=2003|last1=Vuyst|first1=Dimitri De|last2=Vanhoenacker|first2=Filip|last3=Gielen|first3=Jan|last4=Bernaerts|first4=Anja|last5=Schepper|first5=Arthur M. De}} 2. ^{{cite journal|last1=Pearlman|first1=H. S.|last2=Warren|first2=R. F.|title=Tuberculous dactylitis|journal=American Journal of Surgery|date=1961|volume=101|issue=6|pages=769–71|doi=10.1016/0002-9610(61)90724-3|pmid=13733764}} 3. ^{{Cite book|title=Västgöta resa år 1746|last=Linnaeus|first=Carl|publisher=Wahlström & widstrand|year=1978|isbn=91-46-13190-6|location=Stockholm|pages=131}} 4. ^{{cite journal|last1=Subasi|first1=M|last2=Bukte|first2=Y|last3=Kapukaya|first3=A|last4=Gurkan|first4=F|title=Tuberculosis of the metacarpals and phalanges of the hand|journal=Annals of Plastic Surgery|date=2004|volume=53|issue=5|pages=469–72|doi=10.1097/01.sap.0000130708.80606.6a|pmid=15502464}} 5. ^{{cite book|last1=Coombs|first1=R|last2=Fitzgerald|first2=FH|title=Infection in the orthopaedic patient|date=1989|publisher=Butterworth & Co Ltd|location=Great Britain|pages=297–8|isbn=978-0-407-01316-2}} 6. ^{{cite journal|last1=Al-Qattan|first1=MM|last2=Bowen|first2=V|last3=Manteo|first3=RT|title=Tuberculosis of the hand|journal=Journal of Hand Surgery (Edinburgh, Scotland)|date=1994|volume=19|issue=2|pages=234–7|doi=10.1016/0266-7681(94)90175-9|pmid=8014559}} 7. ^{{cite book|date=1995|publisher=Springer-Verla|location=London|pages=99|doi=10.1007/978-1-4471-3011-6_6|chapter=Imaging of Skeletal Tuberculosis|title=Childhood Tuberculosis: Modern Imaging and Clinical Concepts|last1=Cremin|first1=B. J.|last2=Jamieson|first2=D. H.|isbn= 978-1-4471-3013-0}} Reviewed in {{cite journal|pmc=1511729|year=1996|last1=Cant|first1=A. J.|title=Childhood Tuberculosis. Modern Imaging and Clinical Concepts|journal=Archives of Disease in Childhood|volume=75|issue=4|pages=359|doi=10.1136/adc.75.4.359-a}} 8. ^{{cite journal|last1=Salimpour|first1=R.|last2=Salimpour|first2=P.|title=Picture of the month. Tuberculous dactylitis|journal=Archives of Pediatrics & Adolescent Medicine|date=1997|volume=151|issue=8|pages=851–2|pmid=9265892|doi=10.1001/archpedi.1997.02170450101018}} 9. ^{{cite journal|last1=Zoga|first1=A|last2=Lee|first2=V. W.|title=Paediatric case of the day. Tuberculosis dactylitis and primary pulmonary tuberculosis|journal=American Journal of Roentgenology|date=1999|volume=173|issue=3|pages=813, 815–7|pmid=10470936|doi=10.2214/ajr.173.3.10470936}} 10. ^{{cite journal|last1=Bhaskar|last2=Tashi|first2=Konglah|last3=Bareh|first3=Jerryson|title=Tuberculous dactylitis (spina ventosa) with concomitant ipsilateral axillary scrofuloderma in an immunocompetent child: A rare presentation of skeletal tuberculosis|journal=Advanced Biomedical Research|date=2013|volume=2|pages=29|doi=10.4103/2277-9175.107993|pmid=23977657|pmc=3748632}} 11. ^{{cite journal|title=TB or not TB: an unusual sore finger|journal=Emergency Medicine Journal|date=2001|volume=18|issue=6|pages=490–1|doi=10.1136/emj.18.6.490|pmid=11696511|pmc=1725720|last1=Sunderamoorthy|first1=D|last2=Gupta|first2=V|last3=Bleetman|first3=A}} 12. ^{{cite journal|last1=Jensen|first1=CM|last2=Jensen|first2=CH|last3=Paerregaard|first3=A|title=A diagnostic problem in tuberculous dactylitis|journal=Journal of Hand Surgery (Edinburgh, Scotland)|date=1991|volume=16|issue=2|pages=202–3|doi=10.1016/0266-7681(91)90177-P|pmid=2061665}} External links{{Medical resources| DiseasesDB = | ICD10 = {{ICD10|M|90.0}} | ICD9 = {{ICD9|015.5 }} | MedlinePlus = | MeshID = }} 3 : Human diseases and disorders|Tuberculosis|Pediatrics |
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