RT Book, Section
A1 Shah, Ashish
A1 Sobolewski, Brad
A1 Mittiga, Matthew R.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181044607
T1 Dactylitis (Hand-Foot Syndrome)
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181044607
RD 2024/04/19
AB This  painful  vaso-occlusive  condition  is  commonly  the  1st  clinical  manifestation  of  sickle  cell  disease  in  infants.  It  usually  presents  in  children  younger  than  5  years  of  age,  with  nearly  45%  of  first  cases  presenting  prior  to  the  age  of  2.  Patients  are  acutely  ill  with  fever,  leukocytosis,  and  swollen  hands  and/or  feet  that  are  exquisitely  painful  due  to  bone  infarction.  Some  children  may  present  with  fussiness  and  swelling  with  minimal  erythema  or  fever.  X-rays  are  often  normal,  and  it  is  not  until  1  to  2  weeks  later  that  subperiosteal  new  bone,  cortical  thickening,  and  even  complete  bone  destruction  can  be  seen.  The  differential  diagnosis  includes  osteomyelitis,  trauma,  cold  injuries,  acute  rheumatic  fever,  juvenile  rheumatoid  arthritis,  and  leukemia.