Hi Robablo,

My Dups progressed rapidly once it became active. I first noticed nodules forming in October 2008. By February '09, I had mild contracture and had NA to release the contracture. I was in a quandray about which to do first - RT or NA. In May, I had my first consultation at Scripps for RT and we deemed that three spots/areas on my palm could be done then or watch and wait. I couldn't schedule it until July because of my busy-ness . By the time I went for RT less than 2 months later, many more nodules had formed all over my palm and Dr. T decided the whole palm needed RT.

I think it was very fortunate that I had the delay or else just certain spots/areas would have been treated while this sneaky disease was lurking just waiting to pounce. Because of the wait, there was a little bit of contracture that reoccurred which made it harder to hold my hand flat but not enough to affect getting RT.

For me, my left hand is showing active Dups above and below the MCP joint of my forefinger. I have already had a consultation about RT for this and a followup consult, but the radiologist and I agree that it can wait. He said that he wants to do RT before any contracture occurs. So, I'm watching it and if it shows any signs of wanting to contract, I'll have RT. He is aware of my case and ready to go as soon as I call.

It seems that you are about in the stage that I am with my left hand it is unlikely that you have to get RT so immediate if it isn't bothering you much. You might want to get it set up so that if it becomes rampant, you are ready to go. Then again, you are looking at going to Germany so I don't know your time frame for making arrangements and getting over there.

To repeat, I could have had RT in February '09 but had it in July which turned out to be the best timing because of the lurking disease not distinguishable by palpation or other signs.

It needs to be active. Treating healthy tissue does not prevent it from developing. Catching it active is the key and to get RT while active but before contracture. Now, how in the world are any of us supposed to figure out what our Dups is going to do. We don't.

Hope this helps. Any questions?