Hi Australia Calling.I have read from Prof. Seegenschmiedts book an article on Imaging Techniques. He indicates that the imaging techniques for MD/ML are less often required for diagnostic confirmation ,than in other disorders.However he does mention ultrasound and MRI will allow the exact assessment of diameter and depth of key nodules.He goes on to say that a biopsy be done on any unclear findings . Prior to radiotherapy in 07 ,Dr Steffens Essen/Germany carried out ultrasound on both hands. This took only a few minutes to confirm the active growth of Dupuytrens. In my many previous surgeries no scan was done or recommended by any surgeon. Regards.
I did ask my doctor this past week about why he wanted the MRI. He wanted it to give me a good base line picture in a format (CD) that I can take with me anywhere in the world for treatment. He also wanted that base line to be at the beginning of any treament so that any doctor would know what my DC looked like in the beginning. Since he will be doing the RT I will also be able to compare after RT if DC continues any new growth even before I can feel a nodule or cord.
I had a NA performed on both hands by Dr. Denkler and followed with XRT in Germany with Dr. Seegenschmiedt and a second round of XRT with Dr. Snead as UCSF Med Center. Dr. Denkler did not realize the extent of the progression in my right hand which Dr. Seegenschmiedt quickly determined with palpation due to his greater experience. Dr. Snead had me get a CAT scan in part due to her use of a different piece of equipment than was used in Germany and the need to calibrate the exact depth of the expose as the X-rays are focused.
I would question the ability of US doctors to accurately assess the area that should be treated without an MRI or similar means as they lack the hands on experience with DC patients to rely on palpation or contracture or nodules alone.
Yesterday I had an appointment with Dr. Chang in Palo Alto. He is in my medical group and after I met with him 2 weeks ago, he agreed to the radiation therapy. He does treatment for keloid scar tissue among other radiation therapies but has not treated Dupuytren's before. He submitted the paperwork for radiation for Dupuytren's to the medical group and they (I almost fainted) APPROVED the radiation treatment!
Yesterday I had a CAT scan of my hand. Tomorrow I go in for further "simulation". I should be able to get the radiation soon I think.
My medical group, Santa Cruz Medical Clinic, has made me jump through many hoops for this approval. Meanwhile my node and cord have been growing. I'm grateful that they finally did approve the treatment but wish that RT was more in the mainstream here in the US so that this could have happened earlier. Tomorrow I will discuss with Dr. Chang the possibility of his name/information being added to the Dupuytren's list of doctors offering this treatment.
They did an MRI before my procedure to determine the depth of the nodules and cords and to determine the extent of the area to be treated. It might help diagnose areas that need to be treated that could not be determined by a physical hand examination. Though there is added cost, it will cost much more to come back and treat areas again that were missed when you had the first opportunity. Hope this helps.