| Question on terminology and disease presentation |
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11/04/2013 12:57
Ipster 
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11/04/2013 12:57
Ipster
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Question on terminology and disease presentation
I have what is probably a stupid question. 
What is the difference between the thickening of the palmar fascia and a cord?
From the nodule towards the base of my palm I can feel thickness under the skin for about 1.5" but if you look at my palm you can't see anything except a dimple where the nodule is.
When does the thickening of the palmar fascia become characterized as a cord?
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11/04/2013 14:47
newman 
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11/04/2013 14:47
newman
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Re: Question on terminology and disease presentation
Hi firstly I am not a doctor but have had many surgeries for Dupuytrens sometimes called Dupuytren's Contracture . As the name suggests the disease causes contracture of the fingers and palm of the hand. Nodules form into cords which then contract. There is also a Non Dupuytren Palmar fascial disease where there is a thickening of the fascia but does not lead to contracture.
You mentioned you have a dimple in the palm ,which sounds like a nodule is in the involution stage prior to contracting . There is plenty of literature available on this site. At the top of this web page select Treatment -surgery and then literature. There is an article by Kristina & Joseph Shaffer. Also read "Reviews of side effects of Dupuytren Surgery "20yr review by Keith Denkler . Further Select "Disease"-literature and half way down is a pdf download by Vernon LUCK- This will help with understanding of Dupuytrens. Regards.
Edited 11/04/13 17:06
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11/04/2013 14:48
callie
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11/04/2013 14:48
callie
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Re: Question on terminology and disease presentation
My interpretation is that a thickening is a more horizontal spread of the diseased tissue which might happen if the cord is broken (NA, Xiaflex, fasciotomy) and the diseased tissue left in place. It would seem to be more of a disorganized, disrupted cord. An analogy might be like cutting the top of a tree and the resulting structure is a spread out bush like tree.
Having said that, I could be totally incorrect.
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11/04/2013 15:25
Ipster
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11/04/2013 15:25
Ipster
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Re: Question on terminology and disease presentation
I think I'm not being clear in my question. I do have Dupuytren's disease and have been diagnosed by two hand specialists.
If you feel the hard palmar fascia from the nodule towards your palm is this referred to as a cord? If it isn't visible or doesn't extend up into your finger is it still referred to as a cord?
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11/04/2013 15:41
newman
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11/04/2013 15:41
newman
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Re: Question on terminology and disease presentation
Hi in the early stages the cord may not be visible but when palpitating the palm it is easily felt ,particularly by some one other than yourself. The cord can run through the palm from the wrist to the joints in the fingers. Treatment of the cord in the palm is much easier than in the MCP joint or in particular the PIP joint.
Edited 11/04/13 17:43
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