TY - JOUR T1 - TB or not TB: an unusual sore finger JF - Emergency Medicine Journal JO - Emerg Med J SP - 490 LP - 491 DO - 10.1136/emj.18.6.490 VL - 18 IS - 6 AU - D Sunderamoorthy AU - V Gupta AU - A Bleetman Y1 - 2001/11/01 UR - http://emj.bmj.com/content/18/6/490.abstract N2 - 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. ER -