Dactylitis, also known as “sausage digit,” is the inflammation of one or more fingers or toes. It can cause swelling, pain, warmth, and redness in the affected digits and is often linked to certain rheumatologic or infectious diseases.
While the term can technically apply to any finger or toe inflammation, it is most often used to describe cases caused by conditions such as infections, psoriatic arthritis, or gout.
When dactylitis is suspected, it is important to see a rheumatologist or primary care physician. If symptoms are severe or accompanied by fever, seeking immediate medical attention is recommended.
Main symptoms
The most common symptoms of dactylitis include:
-
One or more fingers or toes that are completely swollen and sausage-shaped
-
Warmth in the affected digits
-
Pain in one or more fingers or toes
-
Redness of the skin around the area
-
Difficulty bending the affected fingers or toes
Dactylitis may affect one or both hands or feet. Because of the swelling and inflammation, a person may have trouble walking or performing manual tasks. Depending on the underlying cause, not all digits may be affected in the same way. Additional symptoms such as fever, anemia, or pain in other parts of the body may also appear.
How to confirm a diagnosis
Diagnosis of dactylitis is usually made by a rheumatologist or primary care doctor, based on a person’s medical history and symptoms. The sausage-like appearance of the fingers or toes is often a clear indicator of the condition.
To identify the cause and guide treatment, the doctor may recommend tests such as X-rays of the affected digits, a complete blood count, or blood tests for specific antibodies, including VDRL when syphilis is suspected.
If fever or severe symptoms are present, urgent evaluation is needed to rule out serious infections such as cellulitis or osteomyelitis.
Possible causes
The main causes of dactylitis include:
-
Skin infection
-
Psoriatic arthritis
-
Sickle cell anemia
-
Extrapulmonary tuberculosis
-
Ankylosing spondylitis
-
Gout
-
Congenital syphilis
Dactylitis occurs when the tissues of the fingers or toes—such as bones, blood vessels, tendons, or joints—become inflamed. It is most often related to inflammatory or infiltrative diseases, with psoriatic arthritis and skin infections being the most frequent causes.
Treatment options
Treatment for dactylitis depends on the underlying cause and may include:
-
Antibiotics, in cases of bacterial infection
-
Anti-inflammatory medications or immunosuppressants, for rheumatologic conditions such as psoriatic arthritis or ankylosing spondylitis
-
Pain relievers and intravenous fluids, particularly during sickle cell anemia crises
In people with sickle cell anemia, dactylitis often resolves within a month after treatment of the pain crisis, which usually involves IV fluids and analgesics to relieve symptoms.