Hand-Foot Syndrome

• One of earliest changes of sickle-cell disease  

• Occurs in small bones of hands and feet resulting from infarction  

• Patients are usually less than two years of age  

• First starts with painful swelling  

• Usually in proximal phalanx or metacarpal  

• Periosteal reaction and bone destruction are present

• Heals in a few months  

• Indistinguishable by x-ray from osteomyelitis