• tubercular dactylitis
• spina ventosa

A 17-year-old male presented with a painful swelling of the middle phalanx of the right middle finger of 3 weeks duration. There was no history of trauma. The swelling had slowly increased over 3 weeks. He had mild fever and restriction of motion of the affected finger. On examination the swelling circumferentially involved the middle phalanx, more towards the palmar aspect (fig 1). Local temperature was not raised, mild discoloration of the overlying skin was evident, and the lesion was tender on palpation. No scar, sinus or discharge were seen. The erythrocyte sedimentation rate was 45 mm/h after the first …