A 2-year-old African American child experiences acute pain and symmetric swelling of hands and feet with a temperature of 101°F. What is the likely diagnosis?

The symptoms described in this scenario—a 2-year-old child presenting with acute pain, symmetric swelling of the hands and feet, and a low-grade fever—are indicative of dactylitis, which is often associated with sickle cell disease.

Dactylitis, also known as hand-foot syndrome, occurs due to vaso-occlusive crises in patients with sickle cell disease. In young children, especially those under five, this condition typically manifests as painful swelling in the fingers and toes due to the blockage of blood vessels by sickled red blood cells. The fever observed in the child further supports the diagnosis as it can occur during these acute painful episodes.

The demographic factor also plays a role; sickle cell disease is more prevalent in African American populations, making this diagnosis particularly relevant. This child’s symptoms align perfectly with a classic presentation of dactylitis due to sickle cell disease, thus supporting the likelihood of this diagnosis.

Other options such as aplastic anemia, septic arthritis, and rheumatic fever do not match the combination of symptoms as directly as dactylitis associated with sickle cell disease does, especially in the context of the patient's age and background.