Is it always caused by a nodule close to the PIP or are there any other mechanics that would cause this?

I have a PIP contracture on my small finger. About 35 degrees. I believe there is a nodule close to the PIP joint. A thick cord down to the MCP and a nodule below that and a thin cord down into the palm.

I have a number of other nodules in both palms but no other finger contractures. I have the remnants of a nodule on the other small finger at the PIP that the radiation zapped. I do note a lot of thickening cords in both palms.

If no other PIP nodules noted, I am wondering if the finger contractures that "might" follow would be MCP in nature.

A little history on me. 58 years old, Mother is 83 with bilateral DD but it really doesn't affect her hand function much, she has cords in the palm and some contracture in her small finger. Not sure how long she's had it since I only found out about it after I came down with DD and checked her hands on my last visit home.

My DD showed up about five months ago. Very aggressive. A lot of painful nodules. In both hands. I went for RT (2 weeks @ 2.0 Gy) within 8 weeks of onset. It did noticeably improve my nodules but some other ones continued to develop. I also have tightness in my right shoulder. All this came on at the same time. I interpret the shoulder problem as frozen shoulder. It is tight all the time but I exercise it and I have no issues with any restricted movement or pain. I also have some peripheral neuropathy that my docs feel is related to the DD. Again, it arrived at the same time as the shoulder and the DD. Docs feel the irritation to the nerves in the hands is causing it. Also they have ruled out other systemic issues with blood work, etc.

You can see the fast progression. Different from most who have slow progression over the years. So far, nothing in the feet. Hoping like crazy there. That would suck. I've seen a number of doctors, including two certified hand surgeons. My options will be different than most. I will try NA but may not be an option for PIP contracture like mine. I will also explore one more shot at RT.

Can someone explain to me how a cord can grow along such long lines from one end of the hand to the other. Does a cord grow around something like a nerve or other structure in the hand ? I ask this because if a cord has a useful structure such as a nerve within it then NA could pose a risk.

Cords usually develop in the direction of pulling forces. They do not include useful structures but somtimes they do spiral along nerves which is an issue, but a very rare one, with NA. The danger of damging a tendon when doing NA or Xiaflex is probably bigger.

Wolfgang

@ray:

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Can someone explain to me how a cord can grow along such long lines from one end of the hand to the other. Does a cord grow around something like a nerve or other structure in the hand ? I ask this because if a cord has a useful structure such as a nerve within it then NA could pose a risk.

I had no nodules with my Dupuytren's in my little finger. Only the cord. Finger had 90 degrees contracture and involved both PIP and MCP with cord extending almost to the base of the palm. The contracture all took place in less than one year. I did have the dimples at base of palm that I first thought were calluses.