Dactylitis or Sausage Fingers – Causes, Types, Symptoms, Treatment

Dactylitis or Sausage Fingers is a pathological condition in which there is inflammation of the fingers or toes giving them the shape of a sausage, which gives it its name.¹ The fingers appear swollen and plump and the affected individual finds it difficult to adequately use the fingers. This condition is usually an indicator of potentially some other medical problem like ankylosing spondylitis, sickle cell anemia, or even an arthritic condition. Apart from the fingers appearing swollen and plump, this condition also causes severe pain making it very difficult for an individual to use them adequately.

One of the major causes of Dactylitis or Sausage Fingers is a condition called Sickle Cell Disease and Psoriasis. Some of the other conditions that may cause Dactylitis or Sausage Fingers are Leprosy, Reiter’s Syndrome, TB, as well as Sarcoidosis. In some instances, conditions like psoriatic arthritis, gonococcal arthritis, juvenile chronic arthritis can result in swelling of the fingers or toes thus causing Dactylitis or Sausage Fingers.

Some of the types of Dactylitis or Sausage Fingers are:

Blistering Distal Dactylitis: This type of Dactylitis or Sausage Fingers occurs when there is inflammation of the pads of the finger.² This condition is usually seen in children who are between six months to four years of age. This condition is quite painful and makes it difficult for the child to use the finger.

Sickle Cell Dactylitis: This type usually affects babies up to six months of age and is the primary symptoms of Sickle Cell Anemia.³

Tuberculous Dactylitis: This type of Dactylitis or Sausage Fingers usually affects the bones of fingers, toes, feet and hands. In this type of Dactylitis, the pain stems from deep in the bone as opposed to the surface of skin. This type of Dactylitis or Sausage Fingers is generally extremely painful.

The main presenting symptoms of Dactylitis or Sausage Fingers are swelling and pain in the toes or fingers. At times, there will be swelling and inflammation across the entire foot. There will also be fever along with severe tenderness across the affected region. In some individuals, the inflammation may be to an extent that it may make it difficult for the individual to walk or carry out normal activities of daily living due to inability to use the fingers adequately. Dactylitis or Sausage Fingers is also seen in infants less than one year of age. At times, these symptoms can be thought of as symptoms of another medical condition called cellulitis. The swelling in the pads of the fingers in infants is a clear cut sign of a Sickle Cell Anemia. There may also be tiny blisters seen on the fingers making it extremely painful for the child to move his or her fingers. If Dactylitis or Sausage Fingers stems from deep within the bone and where the entire hands or the feet get affected then this form of Dactylitis is quite difficult to treat.

To make a confirmatory diagnosis of Dactylitis or Sausage Fingers, the treating physician will first take a detailed history as to when the symptoms were observed first. The physician will then conduct a detailed examination of the affected digits. After this, based on the symptoms that the individual is experiencing, the physician will try and find out a cause for the condition. In order to do this, the physician will order a blood test and once a cause for the inflammation is identified the physician will formulate an appropriate treatment regimen. For example if the physician identifies that Dactylitis or Sausage Fingers is present along with a respiratory illness then a thorough lung examination will be performed to rule out tuberculosis as a cause of this disease. If tuberculosis is proved to be the cause then the physician will formulate a course of antibiotics to treat the condition.

The basic treatment for Dactylitis or Sausage Fingers is basically supportive and most of the treatment is dependent on the exact cause of the condition. If an individual has just mild form of swelling and inflammation then the physician may recommend just consuming more fluids and water than normal to keep the body well hydrated. Medications like Tylenol and ibuprofen can also be prescribed for control of pain and swelling. Also, the physician will recommend using hot and cold compresses to the affected area for relief from swelling and calming down the inflammation. In case of severe form of Dactylitis or Sausage Fingers, intravenous fluid administration may be required to keep the individual hydrated. Treatment in an inpatient setting may be required in some cases. A detailed course of treatment plan will be formulated by the treating physician once the cause of the infection and inflammation is identified. In case if the inflammation and infection is caused by a bacteria which is in the case of Blistering Dactylitis then the physician will prescribe a course of antibiotics to eliminate the offending bacteria. In case if an individual is suffering from Distal Dactylitis then the physician may have to incise and drain the fluid out of the affected finger and then prescribe antibiotics and pain medications for controlling pain and inflammation caused due to Dactylitis or Sausage Fingers.

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