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TB or not TB: an unusual sore finger
  1. D Sunderamoorthy,
  2. V Gupta,
  3. A Bleetman
  1. Birmingham Heartlands Hospital, Birmingham, UK
  1. Correspondence to: Mr D Sunderamoorthy, 4 Lakeside Gardens, Merthyr Tydfil, Mid-Glamorgan CC48 1EN, Wales (dsundar6{at}


A 25 year old Afro-Carribean presented to the accident and emergency department with a painful swelling of the little finger. Radiology revealed periosteal elevation and a bone scan showed a hot spot in the proximal phalanx, suggestive of a tumour or an infection. He gave a history of recurrent chest infections in the past, the chest radiograph revealed apical lesions and loculated pleural effusion. Bronchoscopy washings were positive for acid fast bacillus suggestive of pulmonary tuberculosis with tuberculous dactylitis. A detailed history and high index of suspicion is important as delay in diagnosis can have serious consequences for the patient.

  • tuberculosis
  • tuberculous dactylitis
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  • Mr A Bleetman is guarantor of this paper.

  • Funding: none.

  • Conflicts of interest: none.

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