Thank you Wolfgang--
I appreciate what you said and it seems that I'm too late for radiotherapy with my lesions--the cord and nodule that have been there for more than a year on both hands, the cord under another finger that has been there for more than a year on both hands and the large cord and large nodule that has caused ring finger contraction on both hands. I agree I should have treated these at the earliest stage but did not know about radiotherapy.

However, I'm still unsure about the nodule on index finger PIP. As I wrote, it had been thin and almost unnoticeable--certainly stable for years, but in the last months has grown somewhat now it is certainly noticeable and I can't really tell if the very slight tissue prominence under it is the beginning of a cord--at this point it doesn't seem so, but I know it could be. So I guess what I'm asking is--would this kind of situation be worthwhile for radiation? The reason why I'm wanting to be very clear is that it seems from what I've read on the forum--including Wolfgang's posting is that nodules on the PIP and cords under them are not amenable to NA and certainly I don't think doctors will risk doing collagenase on a nodule sitting on the PIP joint. This leaves only kenalog for slowing the situation and surgery to deal with any contracture that will probably come--which probably means early recurrence and then recurrence, etc.

Also, it seems from Dr. Seegenschmiedt's paper that cord and nodule without contraction is still considered early--but probably it has to be that they should have just grown so that there are fibroblasts, which I understand are the "bad" cells, to zap. Otherwise, it may not work if the combo has been stable for some time.

I'd appreciate any comments that would make this as clear as possible for me.

Thank you.

The Dupuytren's in my hands has developed in the last 2 years. I have cords and nodules in both hands, with the left hand being more pronounced, but no contracture. The nodules have just shown up in my right hand the last couple of months. Dr. Herman did not seem to think my left hand had progressed too far for the radiation to help. He mentioned something about catching it within the first few years.

Kline is in fact quite the proponent of post NA Radiotherapy. He has a local radiologist who he refers his local post NA patient to. I would consider it but for all the hoops someone in LA would need to jump through to get someone here to do it.

The cortisone injections he did for me 18 months ago have kept the nodules soft, out of pain and with no recurrence. Still, even cortisone injections are hard to come by in LA where Open Surgery stills rules the day.

It would be helpful if we had a list of MD's who will do either Radiotherapy or cortisone injections.