Dactylitis, or hand-foot syndrome, is frequently the first symptom experienced by youngsters through sickle cell illness (SCD). It is a condition connected via pain and also swelling of the hands and also feet. The swollen areas might likewise be red and also have actually a high temperature.1,2

Dactylitis happens once sickle cells block blood flow in the hands and also feet. It is typically treated modestly because it only lasts for 1 to 2 weeks and also hardly ever leads to permanent joint damage. Treatment entails pain medicines, hydration, and various other means to ease discomfort.

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What is dactylitis?

Dactylitis is the term for painful swelling of the hands and also feet in SCD. It affects babies and also young children from 6 months old to 6 years old. It is most common in the first 6 to 12 months of life. Many children who experience dactylitis have actually sickle cell anemia (HbSS), sickle cell hemoglobin C illness (HbSC), or sickle cell beta thalassemia.3,4

Children with dactylitis have puffy, tender, and warm feet and hands. They might likewise have acute pain, fever before, reduced activity, and also an incapacity to organize weight. Episodes of dactylitis usually go away within a month. Dactylitis might rerevolve, however it generally will certainly not cause any kind of long-term joint damages.5

Why does sickle cell disease cause dactylitis?

Bones are the second-a lot of affected body organ in civilization with SCD, after the spleen. This is bereason red blood cells form in the bone marrowhead, and sickle cells construct up in the tiny blood vessels in bones.6

The develop up of sickle cells deserve to block blood circulation and proccasion oxygen from reaching the bones in hands and also feet. This often leads to pain and swelling in these tiny bones. About 45 percent of human being via SCD endure dactylitis prior to they are 2 years old.4,5

This rate goes down approximately 5 or 6 years old. This is because the bone marrow in the bones of hands and also feet changes as we age. As this happens, the bones in the feet and hands end up being less influenced by sickle cells.5

How is dactylitis treated?

The ideal therapy for dactylitis is normally a mix of pain medicines, hydration, and various other ways to ease discomfort. Drugs commonly provided for moderate pain include:6

Acetaminophen (Paracetamol)Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen?Dipyrone

Treatment likewise commonly involves bed remainder, immobilization, and also use of a warm pack to ease discomfort and also swelling. People should prevent cold packs because significant cold deserve to tighten blood vessels and also reduce blood circulation.7

Episodes of dactylitis may be triggered by:8

Cold exposureDehydrationInfectionInjury

During too much pain via fever, fluids provided by IV may be important.8

Antibiotics might treat or prevent infections that can trigger dactylitis. Children suffering dactylitis should avoid exposure to excessive temperatures and problems, specifically cold.5

Some study has shown that hydroxyurea may prevent dactylitis and mitigate pain in extremely young youngsters. Hydroxyurea might minimize the need for hospital visits and blood transfusions. Eincredibly perkid responds to hydroxyurea in different ways, so its impacts might be unpredictable.5,8

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Written by: Matthew Zajac | Last reviewed: January 2021
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