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Three nodules - not little finger
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01/15/2024 01:08
DanB 
01/15/2024 01:08
DanB 
Three nodules - not little finger

A third nodule that is associated with the pointing finger just appeared on my palm. I do not have a nodule associated with my little finger. This seems odd to me from what I have read. I understand the usual progression is from the ring finger to the little finger. How rare is this, or is there another diagnosis than DD to consider?

The three nodules are causing some contraction but not enough to cause any significant lack of dexterity. I initially noticed a nodule associated with my ring finger on my dominant hand, now I have three nodules.

01/16/2024 07:30
spanishbuddha 

Administrator

01/16/2024 07:30
spanishbuddha 

Administrator

Re: Three nodules - not little finger

I think that contracture most often affects the ring or pinkie, but any or all fingers can be affected including the thumb. In bright sunlight I can see that my entire palm(s) is riddled with signs of the disease. On one hand I also have a nodule below the first or pointing finger. It sounds like you have (slow) ongoing progression, have you made plans for treatment of you should need it?

01/16/2024 17:48
DanB 
01/16/2024 17:48
DanB 
Re: Three nodules - not little finger

"It sounds like you have (slow) ongoing progression, have you made plans for treatment of you should need it?"

Yes, apparently, it is slow. My fingers have been very flexible so that I could bend them backward quite a bit before this. They will still bend backward some, but it is reduced now. I finally looked up some references and confirmed what you reported about multiple fingers.
I have seen an orthopedic hand surgeon for the first two nodules and will see him again for the third one. The first appointment concluded with, "When it gets to 30 degrees, I will do an outpatient needle fasciotomy".
Changing the subject a bit, I asked him about anti_TNF injections, and he said the study had too many adverse reactions. I had read the paper but did not recall it, so I did not challenge him. I later looked it up, and the author explicitly says there were NO adverse reactions. I plan on bringing up the subject again at my next appointment. That will probably be an uncomfortable subject.

01/16/2024 20:28
spanishbuddha 

Administrator

01/16/2024 20:28
spanishbuddha 

Administrator

Re: Three nodules - not little finger

DanB:
"It sounds like you have (slow) ongoing progression, have you made plans for treatment of you should need it?"

Yes, apparently, it is slow. My fingers have been very flexible so that I could bend them backward quite a bit before this. They will still bend backward some, but it is reduced now. I finally looked up some references and confirmed what you reported about multiple fingers.
I have seen an orthopedic hand surgeon for the first two nodules and will see him again for the third one. The first appointment concluded with, "When it gets to 30 degrees, I will do an outpatient needle fasciotomy".
Changing the subject a bit, I asked him about anti_TNF injections, and he said the study had too many adverse reactions. I had read the paper but did not recall it, so I did not challenge him. I later looked it up, and the author explicitly says there were NO adverse reactions. I plan on bringing up the subject again at my next appointment. That will probably be an uncomfortable subject.
I'm not sure where you live but in the UK it is not approved for treatment of Dupuytren's. I think the cost and, well let's say marginal, trial results to date mean it won't be approved here for some time without further evidence. You saw this too https://youtu.be/7cv9aUrHqaI?si=5MQqGDGD0-GpZtee

The surgeon gave a good response IMHO although he could have mentioned other possibilities: unlikely for a surgeon to mention RT, but steroid triamcinolone shots if it takes off fast, and general tips on taking care of and avoiding trauma to the hands.

01/16/2024 21:35
DanB 
01/16/2024 21:35
DanB 
Re: Three nodules - not little finger

I live in the USA. Yes, I saw that YouTube. He did not mention any other treatment and when asked about what to avoid said that there was nothing.

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