TY - CHAP M1 - Book, Section TI - Dactylitis (Hand-Foot Syndrome) A1 - Shah, Ashish A1 - Sobolewski, Brad A1 - Mittiga, Matthew R. A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason PY - 2021 T2 - The Atlas of Emergency Medicine, 5e AB - This painful vaso-occlusive condition is commonly the 1st clinical manifestation of sickle cell disease in infants. It usually presents in children younger than 5 years of age, with nearly 45% of first cases presenting prior to the age of 2. Patients are acutely ill with fever, leukocytosis, and swollen hands and/or feet that are exquisitely painful due to bone infarction. Some children may present with fussiness and swelling with minimal erythema or fever. X-rays are often normal, and it is not until 1 to 2 weeks later that subperiosteal new bone, cortical thickening, and even complete bone destruction can be seen. The differential diagnosis includes osteomyelitis, trauma, cold injuries, acute rheumatic fever, juvenile rheumatoid arthritis, and leukemia. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/10/10 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1181044607 ER -