What Is Dawson's Fingers?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 25 October 2019
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Dawson’s fingers are a distinctive radiological finding in the brain associated with multiple sclerosis. These lesions radiate out from the ventricles and can help diagnosticians distinguish between multiple sclerosis and other diseases that may cause plaques in the brain and spinal cord. Several conditions can cause similar symptoms, like numbness, tingling, and loss of coordination, along with findings on examination that look similar. Key clinical signs can be important for correctly diagnosing disease so the patient gets the right treatment.

Several imaging techniques can be used to locate Dawson’s fingers, including Magnetic Resonance Imaging (MRI). In a scan, a series of ovoid lesions can be seen around the ventricles in the middle of the brain. Images may be taken from above and the side to provide a complete perspective. Three dimensional (3D) imaging allows for even more detailed pictures of the brain. The size of the lesions can vary, depending on how advanced the patient’s case of multiple sclerosis is, along with other factors.

These lesions develop as a result of inflammation in the brain. In patients with this condition, the immune system mistakenly identifies cells in the body as foreign and begins attacking them. This has a profound effect on the myelin sheaths that insulate nerves. As the myelin becomes inflamed as a result of immune attacks, it breaks down, and this interferes with nerve conduction. The inflammation can spread through the brain’s vascular system, causing lesions around the blood vessels.


Over time, a patient with multiple sclerosis can develop Dawson’s fingers, which reach out from the ventricle and into the brain. More remote lesions known as Steiner’s splashes can also be visible in brain imaging. These signs, combined with symptoms and other discoveries made on imaging studies, can help with a diagnosis of multiple sclerosis. Patients can discuss a number of treatment options for the condition, including medications to suppress the immune system and physical therapy to retain coordination.

Misdiagnosis can be a risk. Dawson’s fingers usually only show up in multiple sclerosis cases, but not all patients with the disease have them, and sometimes they appear with other disorders. For this reason, clinicians typically generate a list of features and symptoms to definitively diagnose the patient. If there is any doubt with Dawson's fingers, additional testing may be an option to explore other possible causes. This assures that patients get the right treatment from the start, based on the correct diagnosis.


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Post 2

I didn't know there was anything so definitive to diagnose MS. I'm glad there is something because it helps the doctor know where to go to treat the patient from the time of a firm diagnosis.

Years ago, I know doctors usually confirmed MS by a preponderance of the symptoms, but I thought it was one of those diseases that had to be diagnosed for certain at an autopsy. Maybe having better diagnostic tools will help researchers come up with better treatments, assuming the MS isn't too advanced for treatment by the time the Dawson's fingers show up on a scan.

Post 1

A friend's mother was diagnosed with multiple sclerosis, and one of the things that gave her doctor the definitive answer was Dawson's fingers. Both of them had suspected MS, but the fingers confirmed it. She said the doctor showed her the MRI scans on his computer and said the fingers were very clear, that there was no ambiguity whatsoever.

She had so many of the other symptoms of MS that the Dawson's fingers were just the icing on the cake, so to speak. They were the finding, however, that allowed her doctor to press for her to be considered eligible for disability, since she was only 51 when she was diagnosed. She's done well, but is glad she received the disability benefit.

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