Sausage Fingers (Dactylitis) and Axial Spondyloarthritis

Reviewed by: HU Medical Review Board | Last reviewed: January 2023

Dactylitis is a symptom that can occur with many spondyloarthritis conditions, including axial spondyloarthritis (axSpA). It most commonly occurs in people with psoriatic arthritis (PsA), a type of peripheral spondyloarthritis.1,2

What is dactylitis?

Dactylitis is an extreme swelling of 1 or more fingers or toes that makes them look like sausages. The condition is often called "sausage digit" because of this resemblance.1,2

Along with swelling, dactylitis may cause fingers or toes to look slightly red and deformed. The swelling may come and go. It can be very painful, making it hard to move or bend your digits.1,2

Figure 1. Sausage digit on a finger

A hand with sausage digits, an inflamed and very swollen pinky finger and thumb.

Why does dactylitis happen with axial spondyloarthritis?

People with axSpA have chronic joint inflammation. This inflammation mainly affects the joints in the spine and the joints between the spine and the pelvis (sacroiliac joints). But sometimes other joints become inflamed, including those of the hands and feet.2

Also, long-term irritation can wear away at the bone of the joints. As the body works to replace the lost bone, it can sometimes create too much. This may lead to a growing together (fusing) of the joint. Joint fusion causes the joint to be stiff and hard to move.2

Inflammation of the ligaments and tendons that attach to bone is also common with axSpA. This is known as enthesitis, and it can affect the fingers and toes.2

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How is it diagnosed?

To diagnose dactylitis, your doctor will look for swelling, pain, and redness of your fingers or toes. X-rays, ultrasounds, and magnetic resonance imaging (MRI) also can be used in diagnosis. These tests may show soft tissue swelling and underlying bone abnormalities.1

How is it treated?

Like other symptoms of axSpA, dactylitis may be treated with medicines including:2,3

  • Non-steroidal anti-inflammatory drugs (NSAIDs) – Available over the counter or by prescription, these drugs help relieve pain and inflammation.
  • Biologics – These prescription drugs help slow the progression of the disease by blocking key processes involved in the inflammatory response.
  • Corticosteroids – Commonly known as steroids, these medicines may be used for short-term relief of inflammation.
  • Disease-modifying antirheumatic drugs (DMARDs) – These prescription drugs may help relieve pain and inflammation, especially in people who cannot take biologic drugs.

Other things to know

The prognosis for dactylitis is generally good. With proper treatment, most people can manage their symptoms and go back to their normal lives. But in some cases, dactylitis may lead to joint damage and deformity. Early diagnosis and treatment of axSpA help reduce instances of dactylitis.1

If you have dactylitis, work with your doctor to develop a treatment plan that is right for you. With the right treatment, you can manage your symptoms and get back to doing what you love.

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