A bit of my story............... I have Dups. on both hands and bottom of one foot. It started about 6 years ago in my right hand thanks to research done on this forum, I cancelled a scheduled open hand surgery and I had NA on my right pinkie PIP by Dr. Denkler in July 2007. My finger was totally straight after NA, but unfortunately it only lasted about 6-9 months before returning to pre-NA (about 50 degrees) contracture, but luckily in the last two years it has stayed at the same degree of contracture, I have small nodules in the middle of the palm of right hand. I plan to return to Dr. Denkler to re-do NA. (by the way, I believe I didn't wear my night brace long enough....only 3months.... and hope that it will be more successful next time if I wear it for longer than six months, even though I know PIP joints are harder to correct).

I always thought that Dups. can be precipitated by trauma, as I had fallen twice on my right hand in the past. However out of the blue, and without any trauma to left hand I started to develop some nasty nodules on left hand middle of the palm, at first few and soft, now getting larger and harder. No cords yet and no contracture.... Again, thanks to posts on this forum, and not wanting to wait for cords and contractures, I considered radiation and had my first appointment yesterday with Dr. Tripuraneni at Scripps in La Jolla, CA. Very impressed with him, I scheduled a mapping appointment Oct. 26 and treatment for two weeks starting November 9.

Just to share what he said.....he looked at both hands and my foot. 1) He will definitely do my left hand, where there is no contraction, as he believes the best time to do RT is when the Dups. is active (which I believe it is because I can notice the quick growth in size and hardness of nodules and also I feel itching on that palm). 2)He said to leave the nodule on my foot alone, because it is not bothering me now...I agree. 3) As far as my right hand where I have the contracted pinkie, small nodules and where I plan to re-do the NA in the near future, he said it is best to do Radiation on the hand immediately after the NA when the cords are recently cut, so as to radiate them before scar tissue forms and they get a chance to re-grow...it made sense. I will probably re-do NA with Dr. Denkler beginning of next year, and then contact Dr. T. for radiation right after that like he suggested.

He also said that he doesn't like to do RT on both hands at the same time....Has anyone had RT on both hands together? I am looking forward to my treatment in November in the hopes of halting this nasty, weird disease at least in my left hand. I would appreciate any comments/advice.

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Thanks Chris, I think Dr. Tripuraneni mostly didn't want to do the second hand because the Dups. on that hand is inactive at this time, the nodules have remained the same for about two years, and he feels RT is mostly effective with active Dup. Also he said its better to radiate immediately after NA. So I'll watch the progress in that hand and maybe do NA followed by RT next year.

Where did you have your RT done? who was your doctor?

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Hello LubaM

I too am considering Scripps for RT on my Ledderhose

I was wondering besides the no discomfort reason, why no RT on your foot. I am a little concerned because my nodules do not usually cause me much discomfort but not sure if they are responsible for my present bout of plantar fasciitis.

I really do want to have RT done on them regardless of whether they are causing discomfort or not, since earlier is better.

Would you mind telling me how long you have had the nodule on your foot, size and location?

Thank you

To: aioanne


At the initial consultation with Dr. T. we only agreed to do RT on my left hand because the nodules are getting bigger and harder (but there are no cords or contraction)...that is suppose to be the best time to do RT....Dr. T. felt that if nodules on foot don't bother me and are not growing, I should leave them alone...I'll ask him again when he does the mapping session to prepare for RT for my hand, if he can do RT on my foot.

I have had two nodules on the bottom of my left foot for about 6 years,in the middle of the arch, about the size of a penny and the second one a bit smaller. They never bother me when walking, and I too have chronic plantar fasciitis, but I never thought they were related. For the plantar fasciites I have had multiple cortisone shots, taping of foot and custom made orthodics. Perhaps having the orthodics is what takes away the pressure from the foot nodules and that is why they don't bother me. My plantar fasciitis is in remision for two years.

My Dupuytren's was diagnosed by my GP, dermatologist and my husband's orthopedic surgeon at first glance of my hand. It is classic. They did feel the nodules and cords, too, but it wasn't necessary. Scripps did a CT scan at the planning/mapping consultation. That was to determine the depth so they could set the RT to only go as deep as the nodules, but not necessary for diagnosis.

I don't think we'll hear much about NA after RT because RT seems to be stopping the progression. If it does start up again, I don't see any problem with having NA after RT. If there is contracture, it is best to have NA first according to Dr. T. Even though my cords had been released by NA, the nodules caused tightness across my palm and I had difficulty laying my hand flat for the RT. Curled up fingers would be a problem in getting RT in the right spots and at the right depth. I specifically asked Dr. T if RT could be done again after RT and he said, "Yes". His protocol uses a very low dose.