[What is your diagnosis? Sarcoid dactylitis].

Archives of Iranian Medicine, Volume 12, Number 6, November 2009 603 he patient is a 20-year-old woman who presented with sausage-shaped swelling of the hand’s fingers and toes since two years ago. She did not have pain or arthralgia but she complained of swelling of the fingers and toes and morning stiffness of 30 minutes duration. No other symptom was reported. On physical examination, marked spindling and swelling of the hand’s fingers and toes were observed (Figure 1). No arthritis was noted. Other physical examinations were all normal. Complete blood count showed the following results: white blood cell count: 6.2 (×10/L) with 69.7% neutrophil and 16.6% lymphocyte, red blood cell count: 3.86 (×1012/L), hemoglobin: 11.1g/dL, MCV: 86.8 fL, MCH: 28.8 pg, MCHC: 33.1g/dL, and platelet count: 228 (×10 /L) Serum calcium was 9.4 mg/dL, serum phosphorus was 3.8 mg/dL, and serum alkaline phosphates was 120 U/L. Radiography of the chest, hands, and the feet were also performed (Figure 2).