Dactylitis is severe swelling of your fingers or toes, usually as a result of psoriatic arthritis or another form of arthritis. It’s sometimes known as “sausage fingers” because the shape your fingers may take. Often, dactylitis is the first symptom that people with psoriatic arthritis experience. Between 16 and 49 percent of people with psoriatic arthritis experience dactylitis at some point in time, according to a research review.

Unlike swelling caused by injury or most other causes, dactylitis is marked by swelling of your entire finger or toe. Your finger or toe may also be discolored, and you may experience pain, a warm sensation, or difficulty moving or bending your finger or toe, Cleveland Clinic notes.

Dactylitis may improve as you receive effective treatment for your psoriatic arthritis. Your doctor may also prescribe treatments specifically aimed at treating dactylitis, and certain home remedies — like soaking your fingers in cold water — can help reduce pain or discomfort when you have this condition.

Signs and Symptoms of Dactylitis

Dactylitis can affect one or more fingers or toes, and involves swelling of the entire length of the finger or toe. In people with psoriatic arthritis, toes are affected more often than fingers, and one hand or foot tends to be affected more than the opposite hand or foot, researchers have found.

More often than not, multiple fingers or toes are swollen at the same time.

In addition to visible swelling, dactylitis may involve the following symptoms in your affected fingers or toes:

Pain
Warm or hot sensation
Redness or other color changes
Difficulty moving or bending fingers or toes

Dactylitis can be either acute (temporary) or chronic (ongoing). When it’s acute, dactylitis is more likely to cause redness or tenderness in the affected fingers or toes. Chronic dactylitis, on the other hand, typically involves a finger that is swollen but not red or tender, according to an article in the Journal of Clinical Medicine.

Causes of Dactylitis

Dactylitis typically occurs as a result of psoriatic arthritis, another form of arthritis, or another autoimmune disease. Some of the conditions other than psoriatic arthritis that can cause dactylitis include the following, according to Cleveland Clinic:

Rarely, an infection can cause dactylitis. Infections that may cause dactylitis include:

Dactylitis involves inflammation of many different tissues in your fingers or toes, which has been shown in imaging studies.

It’s not fully understood why, in some people, psoriatic arthritis or another condition leads to this type of swelling.

How Is Dactylitis Diagnosed?

If you experience swelling of your fingers or toes, it’s important to see your doctor to get it checked out — even if you already know you have psoriatic arthritis or another condition that can cause dactylitis. Your doctor will ask you questions about your symptoms and examine your fingers or toes.

If it’s clear that you have dactylitis, your doctor may use one of several methods to assess the severity of your condition. One common and simple method is to count the number of affected fingers or toes. Other, more complicated methods, take into account the tenderness of your affected fingers or toes and their circumference compared with unaffected fingers or toes, as noted in the Journal of Clinical Medicine article.

In some cases, doctors use imaging — such as ultrasound or magnetic resonance imaging (MRI) — to assess the severity of dactylitis in people with psoriatic arthritis. Scoring systems based on imaging test results also take into account more subjective measures that you report to your doctor, such as pain and functional impairment.

Any method of assessing the severity of your dactylitis can be used to evaluate your response to treatments — either for your psoriatic arthritis in general, or for dactylitis in particular.

People who have dactylitis early in the course of their psoriatic arthritis tend to have more severe psoriatic arthritis in general. One study found that out of 177 people with psoriatic arthritis, the 81 who had dactylitis were more likely to have a higher tender or swollen joint count, a higher level of C-reactive protein (a measure of inflammation), and greater joint damage as seen in imaging tests.

Treatment of Dactylitis

Your doctor will recommend or prescribe treatments for dactylitis in the context of your overall symptoms of psoriatic arthritis. Treatment options include medications, physical therapy, and steroid injections in the affected areas, per Cleveland Clinic.

If you have chronic dactylitis that tends to come and go, you may be able to treat pain and stiffness linked to your dactylitis by taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin). Talk to your doctor before taking NSAIDs for more than a few days in a row.

You can also help ease pain and stiffness linked to dactylitis by trying cold therapy, such as soaking your fingers or toes in cold water. You can wrap an ice pack in a thin cloth and apply it to affected areas for 15 minutes at a time several times throughout the day.

Be sure to see a doctor to have your dactylitis evaluated before you try any home treatments. Depending on the cause of your dactylitis, prescription drugs (such as antibiotics for an infection) may be needed.

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Sources

Kaeley GS et al. Dactylitis: A Hallmark of Psoriatic Arthritis. Seminars in Arthritis and Rheumatism. October 2018.
Dactylitis (Sausage Fingers). Cleveland Clinic. February 24, 2023.
Girolimetto N et al. Psoriatic Dactylitis: Current Perspectives and New Insights in Ultrasonography and Magnetic Resonance Imaging. Journal of Clinical Medicine. June 2021.
Dubash S et al. Dactylitis Is an Indicator of a More Severe Phenotype Independently Associated With Greater SJC, CRP, Ultrasound Synovitis and Erosive Damage in DMARD-Naive Early Psoriatic Arthritis. Annals of the Rheumatic Diseases. 2022.

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