Tuberculous dactylitis (spina ventosa) in a 3-year-old child primarily involves which bone structure?

• A Cortical bone causing cortical thickening without marrow involvement
• B Periosteum leading to subperiosteal abscess
• C Synovium of adjacent interphalangeal joint
• D Medullary cavity of short tubular bones of hands and feet, with expansion of the whole bone ✓

Explanation

Spina ventosa (tuberculous dactylitis) is a form of skeletal TB seen almost exclusively in children under 5 years, affecting the short tubular bones of the hands and feet. The infection begins in the medullary cavity and causes enormous endosteal expansion, replacing medullary contents with caseous/granulomatous tissue. The radiograph shows fusiform expansion of the entire diaphysis (hence 'spina ventosa' — wind-blown spine appearance). This is a classic feature of hematogenous TB in children with rich vascular metaphyses in these short bones.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.