Skeletal tuberculosis: dactylitis and involvement of the skull.

A re-emergence of tuberculosis (TB) is occurring world wide in both developed and developing countries. The clinical picture caused by infection with M. tuberculosis may simulate many other disease entities and may result in unnecessary investigations with a delay in diagnosis and treatment. Skeletal TB tends to be isolated to one anatomical site. We report a 6-year-old boy with disseminated skeletal TB with dactylitis resembling sickle cell anaemia and lytic lesions similar to those which are often seen in neuroblastoma, Langerhans' cell histiocytosis and leukaemia. The clinician should be aware that TB can mimic almost any disease and recognise the radiographic appearances of skeletal tuberculous lesions.