Tuberculous Dactylitis (Bilateral Spina Ventosa) of Proximal Phalanx in a 6-Year-Old Girl: A Case Report.

INTRODUCTION: Tuberculous (TB) dactylitis (spina ventosa) is a rare form of extrapulmonary tuberculosis involving the short tubular bones of the hands and feet, primarily in children. Due to its non-specific presentation, the diagnosis is often delayed.

CASE REPORT: We report a rare case of bilateral spina ventosa in a 6-year-old girl who presented with progressive painful swelling of both middle and ring fingers. Diagnosis was confirmed by cartridge-based nucleic acid amplification test, erythrocyte sedimentation rate elevation, positive Mantoux test, and histopathology revealing epithelioid granulomas with Langhans giant cells. The patient received anti-tubercular therapy - isoniazid (10 mg/kg/day), rifampicin (15 mg/kg/day), pyrazinamide (35 mg/kg/day), and ethambutol (20 mg/kg/day) - for 12 months, showing excellent functional and radiological recovery.

CONCLUSION: Early diagnosis and timely management of TB dactylitis are crucial to prevent deformity and disability. Clinicians should maintain a high index of suspicion in endemic areas when evaluating chronic finger swellings.