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

Step 1: Define dactylitis.
Dactylitis means painful swelling of the fingers or toes, usually from inflammation or infarction of the small bones or soft tissue there.

Step 2: Check sickle-cell anemia.
In sickle-cell disease, small blood vessels in the bones of the hands and feet get blocked by sickled red cells. This causes hand-foot syndrome, a classic form of dactylitis seen in young children with the disease. So dactylitis is seen here.

Step 3: Check beta thalassemia.
Beta thalassemia causes bone marrow expansion and skeletal changes over years, such as a widened skull and frontal bossing, but it does not cause painful swelling of individual fingers or toes. Dactylitis is not a recognized feature of beta thalassemia.

Step 4: Check congenital syphilis.
Congenital syphilis can cause a form of dactylitis with symmetrical swelling of the fingers, from periostitis of the small bones. So dactylitis is seen here too.

Step 5: Check tuberculosis.
Tuberculosis can affect the small bones of the hand, causing a cystic swelling called tuberculous dactylitis, or spina ventosa. So dactylitis is a known feature here as well.

Step 6: Final answer.
Dactylitis is a recognized feature of sickle-cell anemia, congenital syphilis, and tuberculosis, but not of beta thalassemia.
\[ \boxed{\text{Beta thalassemia}} \]