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Non-Dupuytren's Disese of the Palmar Fascia
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04/30/2013 21:30
PatJohnston6384 
04/30/2013 21:30
PatJohnston6384 
Non-Dupuytren's Disese of the Palmar Fascia

I have had two hand-specialist orthopedic surgeons diagnose the nodules on my palms as Dupuytren's Disease. Neither of them treat Dupuytren's. Today I had an appointment with a third hand-specialist orthopedic surgeon. He changed my diagnosis to Non-Dupuytren's Disease of the Palmar Fascia. Why? Because he said DD causes no pain, and being as my hands and wrists constantly ache, I don't have DD.

There's no treatment for Non-Dupuytren's Disease of the Palmar Fascia. However, he gave me a cortisone shot in the right wrist. Over the next three weeks I am to compare the pain in the right wrist to the left wrist. Then I have another appointment with him.

It seems only waiting longer than the 4 months I've had nodules will enable the doctors to give me a specific diagnosis. Has any one else out there been diagnosed with Non-Dupuytren's Disease of the Palmar Fascia? If so, can you share your story? Pat in Southern California

04/30/2013 22:24
callie 
04/30/2013 22:24
callie 
Re: Non-Dupuytren's Disese of the Palmar Fascia

Where are your nodules located? Is there any sign of a cord? This isn't a "big deal". You have nothing to do right now if it is Dupuytren's except monitor closely. There is a window of opportunity for RT (see above in "Treatments") while nodules are active and before contraction.

05/01/2013 01:00
cschieber 
05/01/2013 01:00
cschieber 
Re: Non-Dupuytren's Disese of the Palmar Fascia

It's not true that DD doesn't cause pain. I have many nodules and they are all painful. I went to 4 different doctors before I was diagnosed.

05/01/2013 01:13
PatJohnston6384 
05/01/2013 01:13
PatJohnston6384 
Re: Non-Dupuytren's Disese of the Palmar Fascia

I have 3 nodules and cords in my right palm and 1 nodule and cord on my left palm. I have no contractions, but the fingers connected to the cords are stiff, and won't push backwards. Both hands ache, not specifically where the nodules are, but are very sensitive and painful on the top of my hands at times.

I am game to wait and see what happens, but if I do have DD I think NA or RT should be done before a year goes past. I'll continue to monitor what and if more changes happen and compare the wrist that received the cortisone injection to that wrist that didn't.

05/01/2013 14:29
lori 
05/01/2013 14:29
lori 
Re: Non-Dupuytren's Disese of the Palmar Fascia

I had a lot of pain with DD. My nodule, hand and arm ached all the way into the shoulder. It was the pain that ultimately sent me to the doctor. I definitly have DD. The cortisone shot might reduce the pain for a while. I had one prior to RT and it helped for about 4-5 weeks and then the pain came right back.

Lori

05/01/2013 19:19
PatJohnston6384 
05/01/2013 19:19
PatJohnston6384 
Non-Dupuytren's Disese of the Palmar Fascia

My appointment with my third hand-specialist orthopedic doctor was very interesting. He told me he thought I had
Non-Dupuytren’s Disease of the Palmar Fascia. He said I needed to wait long to see what developed before he could recommend any treatment (if ever.) Below is the info in an abstract he sent me.


Abstract

The typical Dupuytren’s disease patient is of Northern European descent with bilateral progressive multiple digital contractures and is genetically predisposed, with a family history. Palmar fascial proliferations sometimes present as a different entity without the typical Dupuytren’s disease characteristics. We identified 39 patients (20 women and 19 men) over a 4-year period with “Non-Dupuytren’s palmar fascial disease”, with unilateral involvement, without family history or ectopic manifestations. Twenty-three patients presented with unrelated complaints and were discovered, incidentally, to have the condition. In 28 patients, prior ipsilateral hand surgery or trauma precipitated the condition. Other related factors were diabetes mellitus and cardiovascular disease. Ten patients had skin tethering and subcutaneous thickening akin to Dupuytren’s nodules and 29 had palmar fascial thickening into ill-defined pretendinous cords. The diseased tissue was in the line of the ring finger in 30 patients. The time from insult to onset of contracture averaged 3.6 months and from onset to follow-up averaged 5.3 years. The condition was non-progressive, or partially regressive, in 33 patients. Seven patients had operations for unrelated conditions and underwent simultaneous fasciectomy without recurrence. Environmental factors, especially trauma, surgery and diabetes, are important in the pathogenesis of Non-Dupuytren’s palmar fascial disease, but these patients do not appear to be genetically predisposed for Dupuytren’s disease. Typical Dupuytren’s disease and Non-Dupuytren’s palmar fascial disease are two clinical entities that run different courses and do not share a similar prognosis. This should be taken into account in future epidemiological and outcome studies.

05/01/2013 19:40
PatJohnston6384 
05/01/2013 19:40
PatJohnston6384 
Reaction to injection of 6 mg of celestone and 1cc of 1% lidocaine for DD confirmation

I had an intense reaction to yesterday's injection in my right wrist of Celestine and Lidocaine.

The doctor told me my response to the injection would help diagnose if my aching wrist pain was caused by DD or carpel tunnel syndrome. He dug the needle around in my wrist and it felt like the dentist digging around in my mouth when he uses Novocaine. It was an unpleasant, but bearable experience. He told me I might have a mild reaction.

At 4:00 this morning pain woke me up.

My headache was so strong I felt like my head was bursting. The pain filled my whole head, like some poisonous vapor. Pounding temples, eyes burning. I felt every heartbeat. A pain ran down the right side of my neck and shoulder and even lower into my back. The injection area isn’t as painful as it was last evening. But pain was still pulsating up my right arm, seeping into the muscles, not on the inside of my arm, but on the outside. My fingers ached, and the top of my hand. I felt like I’m having a terrible flare-up of rheumatoid arthritis. But what was weird was, it only affected the joints on the right side of my body. Both hands were swollen, and the nodule on my left hand ached the worst it has in days.

I emailed the doctor, and his response was that this was not a typical reaction and that he was not sure what to make of my symptoms.

It's 2:38 p.m. now, and, except for the headache, the other pains have dissipated.

For sure Celestine and Lidocaine are going on my "allergic to medications" list.
Pat

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injection   non-progressive   Dupuytren’s   Non-Dupuytren’s   appointment   confirmation   Disease   Environmental   epidemiological   “Non-Dupuytren’s   nodules   cardiovascular   manifestations   pathogenesis   patients   hand-specialist   specifically   characteristics   proliferations   Non-Dupuytren