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The case describes a 6-year-old girl with progressive painful swelling of bilateral middle and ring fingers. Confirmation used CBNAAT positivity for Mycobacterium tuberculosis, elevated inflammatory markers, a positive Mantoux test, and histopathology showing epithelioid granulomas with Langhans giant cells. Treatment with standard anti-tubercular therapy for 12 months plus curettage and structured rehabilitation achieved excellent functional and radiological recovery.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/tuberculous-dactylitis-bilateral-spina-ventosa-of-proximal-phalanx-in-a-6-year-old-girl-a-case-report/447591/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/tuberculous-dactylitis-bilateral-spina-ventosa-of-proximal-phalanx-in-a-6-year-old-girl-a-case-report/447591.png","ImageObject",300,407,{"name":92,"@type":93},"CatatanPagi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is tuberculous dactylitis often diagnosed late in children?","Question",{"text":112,"@type":113},"It presents with nonspecific features, which commonly delays diagnosis. 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It highlights the rarity of bilateral involvement and underscores the need for comprehensive diagnostic evaluation, structured rehabilitation, and discussion on public health implications.  \nAbstract  \nIntroduction: 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 diagnosisis often delayed.  \nCase Report: Wereport a rare case of bilateral spina ventosa in a 6-year-old girlwho 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.  \nConclusion: Early diagnosis and timely management of TB dactylitis are crucial to prevent deformity and disability. Clinicians should maintain a high indexofsuspicion in endemic areas when evaluating chronic finger swellings.  \nKeywords: Tuberculous dactylitis, spina ventosa, pediatric tuberculosis, curettage, rehabilitation.  \nIntroduction  \nTuberculous (TB) dactylitis is a form of extrapulmonary tuberculosis affecting the metacarpals, metatarsals, and phalanges, and typically occurs in young children. The hand is more frequently involved than the foot [1], and the disease is radiologically recognized as “spina ventosa” due to cystic bone expansion caused by granulomatous inflammation [2].  \nCase Report  \nA 6-year-old girl presented to the outpatient department with complaints of painful swelling in the middle finger of the right  \nhand and ring finger of the left hand for the past 8 months (Fig. 1). The swelling was gradually progressive and was associated with mild fever, loss of appetite, and weight loss. There was no history of trauma, tuberculosis contact, or previous antitubercular therapy (ATT) intake.  \nOn examination, both affected fingers showed spindle-shaped swellings that were firmin consistency and tender to touch, with restricted motion atthe proximal interphalangeal joints.  \nLaboratory investigations  \nHemoglobin was 12.2 g/dL, total leukocyte count was 7480/cm  \n\n| \u003Cbr>Access this article online\u003Cbr>\u003Cbr>Website: [www.jocr.co.in](www.jocr.co.in)\u003Cbr>\u003Cbr>DOI:\u003Cbr>[https://doi.org/10.13107/jocr.2025.v15.i12.6494](https://doi.org/10.13107/jocr.2025.v15.i12.6494) | Author’s Photo Gallery |  |  |\n| --- | --- | --- | --- |\n|  | | | |\n|  | \u003Cbr>1Department of Orthopaedic Surgery, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India.\u003Cbr>Address of Correspondence:\u003Cbr>Dr. Rahul Gupta,\u003Cbr>Department of Orthopaedic Surgery, Lala Lajpat Rai Memorial Medical College, Meerut-250004, Uttar Pradesh, India.\u003Cbr>E-mail: [rahulgupt007@gmail.com](rahulgupt007@gmail.com) |  |  |\n| Submitted: 18/09/2025; Review: 07/10/2025; Accepted: November 2025; Published: December 2025 |  |  |  |\n| DOI: [https://doi.org/10.13107/jocr.2025.v15.i12.6494](https://doi.org/10.13107/jocr.2025.v15.i12.6494)\u003Cbr>© The Author(s). 2025 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-n","cbCainlmAsQqqaXo","https://ap.wps.com/l/cbCainlmAsQqqaXo","pdf",6878786,"English","# Learning Point of the Article\n# Abstract\n# Introduction\n# Case Report\n## Laboratory investigations\n# Radiological findings\n# Pathological findings\n# Treatment\n# Follow-up\n# Conclusion","[{\"question\":\"Why is tuberculous dactylitis often diagnosed late in children?\",\"answer\":\"It presents with nonspecific features, which commonly delays diagnosis. The article emphasizes early recognition to prevent long-term disability.\"},{\"question\":\"How was the diagnosis confirmed in this case report?\",\"answer\":\"Diagnosis was confirmed using CBNAAT positivity for Mycobacterium tuberculosis, elevated ESR, a positive Mantoux test, and histopathology showing epithelioid granulomas with Langhans giant cells and caseous necrosis.\"},{\"question\":\"What treatment approach led to recovery in the 6-year-old girl?\",\"answer\":\"She received standard anti-tubercular therapy for 12 months (isoniazid, rifampicin, pyrazinamide, ethambutol) and underwent surgical debridement and curettage, followed by physiotherapy and finger mobilization. The outcome was excellent functional and radiological recovery.\"}]","Tuberculous Dactylitis - Bilateral Spina Ventosa of Proximal Phalanx in a 6-Year-Old Girl - A Case Report | PDF",1790721661]