"I guess my major concern is what the progression will be as I get older."
With increasing age progression typically slows down. Although there is no guarantee for slower progression, everyone is different, there is no need to be concerned either.

"Are there any forum members in Western Australia who have any local knowlege, experience or recommendations regarding specialists in this field."
You might have a look at http://www.dupuytren-online.info/NA_list..._countries.html. Although you are likely not yet a candidate for NA/needle fasciotomy (requires 20-30 degrees contracture) Dr. Flemming in the Perth area might be able to advise.

Wolfgang

I can't tell you much about DD procedures in Australia, but your experience with DD sounds similar to mine. My DC started when I was in my mid 30s. At first I didn't know what it was. A visit to a hand specialist 20 years later revealed that I had advanced arthritis in my thumbs and needed surgery, but no mention was made of the nodules and cords that were growing in my left hand and curling it, I guess the doc thought it was part of the arthritis. I finally diagnosed the DC myself, went to see another hand specialist and was told I needed to schedule surgery for a fasciectomy. Since I couldn't take the time off from work for rehab (I work with my hands), I postponed the surgery. After I retired I decided to go ahead with the surgery. Then I heard about Xiaflex (Xiapex) and decided that it sounded like a procedure worth trying. Last year, at age 70, I had the injection done and I am quite pleased with the results. After 1 year I am still able to hyperextend my left hand by 30 degrees and the cord remnants are barely noticeable. I will have the same procedure done by the same dr if the nodules develop into cords in my right hand. I think success of any procedure, especially injection, depends upon the skill and knowledge of the practitioner.