Can MSK imaging show dupuytrens disease that is just beginning in fingers (to determine radiation field for non contracture, early dupuytrens disease, if you cannot palpate anything but feel pain in fingers or is MSK usually used only for Ledderhose
MSK stands for ultrasound imaging of musculoskletal disorders which may include Dupuytren Disease. There are a few recent publications available which describe the typical features and capabilities of this imaging method which allows to visualize distinct findings in the hand palm related to Dupuytren Disease. It also helps to distinguish other possible causes of sometimes painful nodules and cords, e.g. ganglion cysts or inflammatory tendonitis or a painful neuroma.
However, it is very doubtful, that ultrasound imaging will detect "Dupuytren Disease" earlier than any palpatory finding, either by the patient himself / herself or an experienced physician, which would mean that we would have a screening tool available for so far undetectable cases.
Ultrasound examinations can only detect and define certain criteria of existing tissue alterations, such as:
- specific location and depth of the lesions in relation to joints (e.g. MC and MCP joints) - specific lesion dimensions (in millimeter; follow-up comparison) - characteristic echo-quality (typically most are "hypoechoic") - characteristic reaction to compression (typically most are "noncompressible") - a few (mostly older) lesions may contain calcifications - eventually increased blood supply ("hyperemia") can be detected by Color Doppler Ultrasound
A recent study on the use of ultrasound imaging for early detection was published by Morris et al (2019)
Thank you so much for your response! I would also like to know if pain in the fingers is indicative of the disease spreading in the finger if cords are too tiny to palpate. My ring finger and pinky hurt all the way to the top but no new nodules or cords, maybe a tiny cord at base of pinky, and a new cord to thumb now since my first radiation area, which did not include thumb cord or finger area, only part of palm. I meet with my RO next month, because of progression outside of first radiation area, which did not include my thumb cord or my fingers, if RO chooses to expand field: is it better to continue with 5 day protocol with expanded field and then after 12 week break do newly radiated area and block first area so all has 30gy total or is it better to do a 7 day protocol with 21 gy after a 12 week break from first radiation area which had 21 gy plus old area of 15gy, so get 36gy total. My RO said he has not run into this progression before, so I am just curious what others have done if had progression outside of first radiation. I realize you can only give me general advice, and that it is not specific to my case but surely others have had progression during the break after first radiation of 5 days, but before their next radiation of 5 days. Please let me know what was done in other cases of progression mid radiation treatment.
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