Sausage digit is not a tasty meat product. It is a group of symptoms indicating the presence of one of several lesser-known arthritis conditions. It looks a lot like its name sounds. A finger or toe swells from tip to base, shaped like a cocktail sausage.
It can involve just one finger, toe or all five digits of a hand or foot. Examples of other symptoms, when sausage digit is associated with fingers, may include ulna nerve pain, sleeplessness, fatigue, and swelling extending into the hand and wrist. The condition can be disabling if not pursued with perseverance, determination and team work between patient and medical professionals.
Moist heat, like paraffin bath therapy, can bring pain relief for better mobility. Over-the-counter non-steroidal-anti-inflammatory drugs (NSAIDs) like ibuprophen, naproxen sodium or other aspirin-related products may also help. But because it affects ligaments and tendons which do not have good blood oxygen supply, healing from sausage digit is slow.
Sausage digit is not a diagnosis by itself. It is a sign pointing to one of the arthritis auto-immune disorders. A rheumatologist diagnoses sausage digit, also known as dactylitis.
Diagnosing and Resolving
Before a referral to a rheumatologist, other possible medical issues should be ruled out. Swollen digits can indicate any number of things, from a spider bite to bone or joint issues and more. A licensed general practitioner will not only need the patient’s full disclosure of medical history, but will order blood tests and probably x-rays. It is common to be referred to a hand or foot orthopedic specialist for better insight to rule-out bone and joint issues.
A short-term prescription of steroids may also be ordered, if dactylitis is acute. If steroids do not alleviate the issue and orthopedic conditions are ruled-out, the orthopedist may decide to refer the patient to a rheumatologist.
It may seem exhaustive to see a third doctor, but the symptoms can mean one of many different conditions. The rheumatologist will need a complete medical history, because past viruses and chronic conditions may be the key to the underlying cause of a sausage digit attack. Blood will be taken so tests may be done for specific disorders.
According to the Arthritis Foundation, disorders which may consist of dactylitis symptoms include Psoratic Arthritis, Reactive Arthritis, Juvenile onset Spondyloarthritis, Ankylosing Arthritis and Undifferentiated Spondyloarthritis (USpA). Exact diagnosis is sometimes difficult because symptoms are the same for some of these conditions. However, treating them with perseverance may end symptoms entirely.
While results of blood tests are in progress, the rheumatologist may suggest orthopedic physical therapy to keep the digits from becoming more disabled. This may reverse dactylitis without any further protocol for some less severe tendon and ligament inflammation.
If inflammation continues or worsens, methotrexate may be prescribed. It is commonly taken in pill form for many auto-immune disorders and certain cancers. A folic acid supplement may be suggested to prevent hair loss and mouth sores; common side effects from methotrexate. Treatment duration is determined by each individual situation.
If methotrexate does not stop dactylitis, an anti-tumor necrosis factor (anti-TNF) drug may be added to help resolve the tendon and ligament inflammation. Examples of anti-TNF drugs are Humira, Enbrel and Remicade. None are available in generic yet, and some insurance companies will not cover them because of their high cost. However, some drug companies are generous in supplying rheumatologists with samples, so patients can at least do a trial to see if it will help their dactylitis before investing a lot of their own money into a medicine that may not work for them.
The Bottom Line
Sausage Digit is a symptom of another medical issue. Diagnosis of the cause can take many months, depending upon individual circumstances. But a combination of physical therapy and medications can bring an end to this severe ligament and tendon inflammation. Perseverance is the key in this painful and sometimes disabling condition, also known as dactylitis.
Sources
Dr. Jeffery Lisse, MD & Dr. Todd Hofeling, MD, UPH Medical Center Rheumatology, Tucson, Arizona
Arthritis Foundation, www.arthritis.org
The Journal of Rheumatology, www.jrheum.com
Article Author, Lynn Pritchett, dactylitis patient
Reference:
- Paraffin Bath Therapy for Pain Relief www.associatedcontent.com/article/1922932/how_to_use_paraffin_therapy_at_home.html?ca
- 5 Signs of Childhood Arthritis www.associatedcontent.com/article/2116135/5_signs_of_earlyonset_childhood_arthritis.h
