CPHON Practice Exam 2025 – Complete Study Resource

Dactylitis, often referred to as "hand-foot syndrome," is indeed commonly recognized as one of the earliest symptoms in patients with sickle cell disease (SCD). It manifests as painful swelling of the hands and feet due to vaso-occlusive crises, where sickle-shaped red blood cells occlude blood vessels, leading to tissue ischemia and inflammation.

This condition is particularly prevalent in infants and young children with SCD, as they may not have developed the ability to communicate pain or discomfort effectively. The painful swelling associated with dactylitis can serve as a significant indicator that prompts further evaluation for SCD, especially in pediatric patients.

In the context of the other options, while joint swelling, fever, and nausea can also occur in SCD patients, they are less specific or may develop in response to other complications associated with the disease. Joint swelling can be associated with pain crises but is not necessarily the first symptom. Fever can indicate infection or crisis but is not directly associated with the development of dactylitis. Nausea is not a typical first sign and could happen due to various reasons, including treatment side effects or other health issues. Thus, recognizing hand-foot syndrome as an initial sign is crucial for timely diagnosis