Your hands - check them

[1der]

Bit off of van topic info but since lots of us work with our hands, or do sports with our hands , I thought I would share my new found knowledge of a condition called Dupuytren's Disease (DD)

Quite a bit of information out there if one knows what to look for.

What is it? - a condition where the fascia around the tendons in the palm and fingers begins to harden and contract. This creates hard nodules and stiff chords potentially leading to bending of a finger which is called a contracture.

Here are a few pictures of my right hand fully stretched out:


Here are a few informative pics:


There is no cure.

There are treatments for the condition but one of the treatments requires early diagnosis of the condition. The initial condition can be confused with a callous, they look similiar. The callous will likely look and feel the same over time. A DD nodule may stay the same for years, before progressing. Or may never progress. Heredity is a strong component in DD, so if a family member has it, there is a higher probability of it being a genetic based condition.

The key is to look at one's hands and keep a record of any changes. The DD condition can activate and change in a matter of days to more apparent nodules/chords. Early detection of the condition is crucial so it can be treated with Radiotherapy (RT) which can in most cases stop or significantly slow the progression and negate any further need for treatment. If you see a change, get it diagnosed and consider early treatment.

Many USA hand surgeons do not acknowledge RT as beneficial and recommend waiting until the contracture has progressed before doing a surgery or other treatment. The problem with this approach is it moves RT off the plate as a viable treatment. Left long enough, IF the disease progresses, then one or more of the fingers are curled into palm. Amputation of the finger might need to be the ultimate treatment if left untreated or ignored AND if the disease progresses to that point.

The insidious aspect of DD is it can just slightly show up, stop, and then stay that way for years or for the rest of one's life. Or it can flare up and progress a bit more and stop. This is why it is important to keep tabs on it, if you have even a small nodule or bump.

You can search for images of hands after DD surgery, just make sure you are not squeamish.

So, have a look at your hands once in a while and feel the palm for any bumps along the tendons leading to the base of your fingers. If you feel anything, start doing your research about this disease, it is more common than one would expect and the prevalence increases with age.

My personal experience over 20 years has been misdiagnosis and treatment for a wart. Lots of liquid nitrogen applications and even a very painful biopsy*. This was through my primary doctor and dermatologists. It was not until 5 years ago or so that I was able to self diagnose because the condition had progressed to being visually very apparent vs had I known what to feel for. Because of the delays, I am not a strong candidate for RT on my middle finger since there is much lower likelihood of success.

* The biopsy in this case may have "activated" the DD to a faster rate of progression due to the trauma of the deep sample taken.

There is a FaceBook page called DART Dupuytren's Advocates for Radiation Therapy, also some good forums, including ones for climbers and cyclists. This happens quite bit in those sports.

Hope this helps at least one person.:d8:

 

[Mikerson]

Thanks for the heads up and very informative post! Best wishes for getting some treatment to maintaining your mobility!

 

[geoffff]

I have it, too. Though mine has not progressed as much.


It's strongly linked to men with northern European ancestry.

 

[marret]

Thanks for posting this Ray. Wish you the best.

I don’t have it, but I sure have more than my fair share of other issues.

 

[86Scotty]

That stinks Ray! I have trigger finger (It's also known as stenosing tenosynovitis, so the Google AI overview tells me). When I first looked at your pics ,before reading, I figured you had some form of that as well.

I have to get occasional cortisone shots to keep my condition at bay. It really only bothers me when I'm working with my hands a lot though, which is not nearly as often as it used to be.

Do you have much pain with this?

 

[vandiesel]

Ray, That is a bummer. Hopefully it is very slow in getting worse. Does is make your hands easily cold as well?

 

[rj-rv]

Thank you for posting this. I have a lump on my left hand about an inch down from my middle finger. My previous doctor thought it was a cyst. He retired so I have a new Dr. so I will show it to him and will be monitoring my hand more closely.

 

[rallypanam]

Yikes! I developed trigger finger on my clutch hand in Baja this year.. it's weird. But not like that! Take care of yourself Ray, you got like another 40 years based on your family!

 

[1der]

Thank you everyone.

I am just happy to help expand awareness around this.

If identified/diagnosed early then the RT treatment can be quite easy and successful. But that is a short window and the condition can activate and advance rapidly. RT has been used in Europe as a treatment for DD in for decades. USA hand specialists are typically not familiar or accepting of RT as a treatment and very often suggest waiting to see if the contracture progresses to 30 to 45 degrees before doing surgery. Far too late in the progression for RT.

rnj - look for a hand specialist that has an open mind around RT for early treatment. Having a hand specialist AND and a Radiation Oncologist that know how to work together. This link is to a searchable list of Radiation Oncologists: https://dupuytrens.club/

Not painful except when an edge of something hits the joint in the middle finger, that is very sensitive. Stretching the hand to place it flat on a surface creates a discomfort as the hardened tissue is being stretched.

Re: Cannot say my hands are more sensitive to cold or hot. I have always needed warm gloves for winter/cold activities. Lately, I have been stuffing a heat packet into my ski gloves on cold days.

 

[yonah-SMB]

My wife's late grandfather was a lifelong master stonemason and had this condition in both of his hands. I remember him telling me that his dr. believed it was exacerbated by his repetitive grasping and shifting of heavy, flat stone tile. Geoffff's comment about it being linked to northern European heritage seems to track in his situation as well.

I wish you all the best Ray in your treatment. Head, hand, and foot injuries are never easy. Thank you for the post and bringing awareness to DD.

 

[joefromsf]

Ray, I think we talked about DD the last time we were together. It's very useful to share this information, so thank you for that.


My dad had it pretty bad and ended up getting the surgery. Think it was when he couldn't put his hand in his pants pocket due to the bent finger that he finally sought medical attention.


His experience gave me the knowledge to self diagnose when I noticed a stiff chord in my palm below the ring finger. My PCP confirmed, but luckily for me there hasn't been any changes over 25 years.

 

[Ramjet-SMB]

There's also a strange association between Dupuytren's contracture and excessive alcohol and barbiturate use. Probably have to dig up the old docs to find any who remember that in their diagnosis though.

 

[BroncoHauler-SMB]

...USA hand specialists are typically not familiar or accepting of RT as a treatment and very often suggest waiting to see if the contracture progresses to 30 to 45 degrees before doing surgery. ....

Ray, first off sorry to hear about this and best wishes. Second, is it the Dr's not being familiar, or is it the insurance companies are reluctant to accept this treatment? Many times the Dr's are ignorant or unaccepting of treatments unless the insurance companies give their blessing.


Herb

 

[1der]

Hi Herb, seems to be the US Drs not accepting RT as a treatment. The disconnect comes where the hand surgeons want to cut and are not trained to do radiation therapy. The radiation Dr knows radiation but is not a hand specialist. The insurance will pay for both.

What needs to happen is the hand surgeon/ specialist should become familiar with the benefits / application of RT and prescribe that as a treatment,
if warranted.