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Case Reports
. 2023 Oct;13(10):137-140.
doi: 10.13107/jocr.2023.v13.i10.3966.

Digital Physeal Arrest Following Dactylitis in a Child

Nadya Liyana Ow  1 , Matthew Nottage  1 , Peter Bale  2 , Pranai Buddhdev  1
Affiliations
Case Reports

Digital Physeal Arrest Following Dactylitis in a Child

Nadya Liyana Ow et al. J Orthop Case Rep. 2023 Oct.

Abstract

Introduction: Following trauma, premature growth arrest is a common outcome when the injury affects the pediatric growth plate. Dactylitis describes global inflammation affecting one or more digits in the hand or foot. It occurs in various seronegative arthropathies and septic arthritis. Physeal fusion following dactylitis is uncommon and is not described in the current literature.

Case report: We report the case of a 12-year-old boy, whose minor non-penetrating injury resulted in circumferential edema of his left third upper limb digit, typical of dactylitis. No evidence of infection was found during clinical examination or blood work. Significant stiffness of the digit remained over the course of a few months with spontaneous resolution following functional hand therapy. The child presented to pediatric orthopedics with cessation of longitudinal growth. Evidence of premature physeal fusion of the involved phalanges was confirmed on radiographs.

Conclusion: Growth arrest following dactylitis has not previously been reported. Clinicians managing this condition should be aware of this rare complication. We recommend that inflammation is treated promptly, and patients are monitored clinically and radiologically to address any potential functional deficit.

Keywords: Dactylitis; growth arrest; orthopedics; pediatric orthopedics; premature growth arrest; rheumatology.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Anteroposterior and lateral radiographs demonstrating the normal length of the middle finger with soft-tissue swelling during acute dactylitis episode (aged 12).
Figure 2
Figure 2
Anteroposterior and oblique radiographs demonstrating complete premature growth arrest of middle finger metacarpal and phalanges with shortened digit (aged 14).
Figure 3
Figure 3
Clinical photograph demonstrating short left middle finger aged 14 years (palmar view).
Figure 4
Figure 4
Clinical photograph demonstrating short left middle finger aged 14 years (dorsal view).
Figure 5
Figure 5
Clinical photograph demonstrating functional handgrip with normal MCP contouring.
See this image and copyright information in PMC

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