Spina Ventosa of the Right Second Metacarpal in an Indian Girl With No Pulmonary Involvement: A Rare Case

Tuberculosis (TB) of the small bones of the hand is rare, especially in children.Isolated metacarpal involvement is even less common.We report a rare case of isolated TB of the second metacarpal in a fiveyear-old Indian girl without pulmonary or systemic involvement.She presented with localized pain and swelling over the dorsum of the hand.The diagnosis was challenging because of nonspecific clinical features and the absence of constitutional symptoms.Cartridge-based nucleic acid amplification testing confirmed Mycobacterium tuberculosis, allowing timely initiation of weight-based antituberculous therapy.This case emphasizes the need to consider skeletal TB in children with persistent, unexplained hand swelling, even without evidence of pulmonary disease.