Even though it feels like I've had DD forever I continue to find out how much I don't know about the disease. Since my husband now has DD (he has a family history although I like to tease him that he "caught it" from me) in the palms of both hands and possibly LD lumps, I have some questions.

As far as I know, conventional wisdom is that you can't get NA until you start to have contractures. Although he doesn't yet have contractures, we can definitely feel the cords not only on their way up to his ring finger on both hands but he also has a cord going down from the nodules toward his wrist. Has anyone ever had this?

We know he's a candidate for RT and after my NA need to start figuring that out but my question is--is there a reason he couldn't have NA on the cords before they reach the MCP joint, before he starts getting contractures? There're definite palpable cords. He's scheduled to have a consult w/Dr. Pess when I have my NA but I wonder if we should ask the question about NA for him ahead of time.

Thanks,
Diane

Diane, I believe that a cord running from a nodule into the palm and towards the wrist is a normal symptom. I have it, too.

Wolfgang

moondanc:

---

... Although he doesn't yet have contractures, we can definitely feel the cords not only on their way up to his ring finger on both hands but he also has a cord going down from the nodules toward his wrist. Has anyone ever had this?
...

LubaM.:

---

Hi Diane,
Interesting questions...
I'm sure Dr. Pess can tell you for sure, but my understanding is also that you can't have NA until you have a contracture. Isn't the purpose of NA to cut the cord and straighten the finger? When you say your husband has DD in the palms of both hands and possibly LD lumps... does he have cords as well as nodules in the hands?

One thing is for sure, he would benefit from RT for the LD lumps, and in my opinion, the sooner the better. I have had good luck with RT, especially for my LD.

Again, best of luck to you with Dr. Pess and please let us know what his opinion is for your husband.
LubaM.

wach:

---

It's the fingers that are contracting, not the palm. A cord in the palm usually does not cause a problem.
Wolfgang

Diane,

the problem is that after the needle procedure you need to pull heavily on the cord to break it. The usual advice is to wait until you have 20 deg contracture and then intervene. A few docs will use NA earlier and try breaking the cord by hyperextending the finger. If you have no contracture at all pulling on the cord will be difficult. Even if you are able to break the cord, without prior contracture the open ends of the cord will stay so close together that they will likely grow together again.

Another option would be what good old Dupuytren had done: a knife fasciotomy. The skin is opended and the cord is cut with a surgical knife. You might even remove a segment of the cord to delay recurrence ("segmental fasciectomy"). But that's a major intervention, will cause scar tissue and might trigger Dupuytren's elsewhere. Personally I wouldn't do it but rather wait until I have a real issue with the cord.

Wolfgang

moondanc:

---

...
However, my husbands case is the same as mine originally was. Nodules in him palm-- both hands, cords coming out of the nodules working their way up toward his ring finger. Hopefully a year or more before contracture-- BUT there's a palpable cord-- why can't this be cut, why does one have to wait for a finger contracture?

Thanks,
Diane