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Small bumps to side of fingers... more DP?
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12/20/21 00:50
noodles12 
12/20/21 00:50
noodles12 
Small bumps to side of fingers... more DP?

Hi all - background: 34yo male with a contracture of my left pinky PIP+DIP joints (~90degs unsplinted) but otherwise no clear symptoms of DP or related conditions.

I have noticed that I have 2 small bumps on the side of my right middle finger, like little callouses. The one next to the DIP joint has been there for at least a year. The one near the PIP joint I believe is newer - only noticed it recently. My concern is that it seems there is some progression here, and due to my age I know the risk for 'aggressive' DPs may be higher.

I would like to know if this is a recognised presentation for early stage DP that may develop into a contracture? Anyone have any experience with this kind of bump?

Photos attached (Apologies, it's quite difficult to see the bumps since they are pretty small and don't contrast so I've drawn some arrows)

[Edit: Higher quality photos here: https://imgur.com/a/PG5JkcN, for some reason the photos come out quite blurry on the forum upload]

Edited 12/20/21 00:52

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bumps.jpg bumps.jpg (7x)

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bumps 2.jpg bumps 2.jpg (7x)

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12/20/21 03:09
Prof.Seegenschmiedt 
12/20/21 03:09
Prof.Seegenschmiedt 

Re: Small bumps to side of fingers... more DP?

noodles12:
Hi all - background: 34yo male with a contracture of my left pinky PIP+DIP joints (~90degs unsplinted) but otherwise no clear symptoms of DP or related conditions.

I have noticed that I have 2 small bumps on the side of my right middle finger, like little callouses. The one next to the DIP joint has been there for at least a year. The one near the PIP joint I believe is newer - only noticed it recently. My concern is that it seems there is some progression here, and due to my age I know the risk for 'aggressive' DPs may be higher.

I would like to know if this is a recognised presentation for early stage DP that may develop into a contracture? Anyone have any experience with this kind of bump?

Photos attached (Apologies, it's quite difficult to see the bumps since they are pretty small and don't contrast so I've drawn some arrows)
https://imgur.com/a/PG5JkcN
[Edit: Higher quality photos here: https://imgur.com/a/PG5JkcN, for some reason the photos come out quite blurry on the forum upload]

Is it possible to send the full photo of both hand palms to the forum for better evaluation ?

12/20/21 05:47
noodles12 
12/20/21 05:47
noodles12 
Re: Small bumps to side of fingers... more DP?

Photos of palms here: https://imgur.com/a/0xqMN9a

You can see the bent left pinky - other than that I am not aware of any DP symptoms in my hands (other than these bumps I'm asking about potentially). I have a few callouses from weightlifting at the gym.

Edited 12/20/21 05:51

12/20/21 09:09
spanishbuddha 

Administrator

12/20/21 09:09
spanishbuddha 

Administrator

Re: Small bumps to side of fingers... more DP?

noodles12:
Photos of palms here: https://imgur.com/a/0xqMN9a

You can see the bent left pinky - other than that I am not aware of any DP symptoms in my hands (other than these bumps I'm asking about potentially). I have a few callouses from weightlifting at the gym.
I will leave ProfS to give a reply based on his experience, but given the active use of your hands I wonder if you have early signs of Heberdens nodes on those joints? https://www.webmd.com/osteoarthritis/heb...uses-treatments I think a physical examination would make things clearer.

12/20/21 16:24
Prof.Seegenschmiedt 
12/20/21 16:24
Prof.Seegenschmiedt 

EVALUATION of PHOTOGRAPHS for DIAGNOSIS of DD

noodles12,

thank you very much for sending the full PALMAR VIEW of your left and right hand to the DUPUYTREN FORUM ....

My currently limited but still available conclusion from both photographs are as follows:

(1) Not seeing both hands in active motion (possible during VIDEO CONSULTATION)
no comparative judgement between both hands is possible regarding function

The almost 90-degree (not %!) flexion deformity of D5 (little finger) in the DIP & PIP joints
is characteristic and significant for Dupuytren Disease affliction (often occurring in D4 & D5);
a possible differential diagnosis could be insufficient extension due to trauma at that finger.

(2) Not being able to compare spreading function and vertical lift-up (possible during VIDEO CONSULTATION)
no comparative judgement between both hands is possible regarding maximum values

The spontaneous spread of D1 to D2 is narrower than on the left side (about 5 degrees);
maximum spread could be examined or should be tested in VIDEO CONSULTATION

(3) Static photographs in comparison of the right and left palm and show asymmetric findings
regarding the different SURFACE RELIEF of both hand palms; in addition, differences occur
in the left-HAND PALM marked as nodules (GREEN), cords (BLUE), wrinkles (BLACK) and
Angulation of digit 5 (YELLOW)

In summary,
I would be surprised if I would not find more signs of and thereby affirm the diagnosis of an
early Dupuytren Disease with advanced signs in D5 in a further SPECIAL VIDEO CONSULTATION

Attached are your photographs worked up by myself for clarification of the findings defined above.

As a young patient you may carefully explore DD risks (family, sports? , predisposing factors?)
and get your feet explored as well !

WISH YOU ALL THE BEST and EXPERIENCED PHYSICIANS serving you well in the future ....

Edited 12/20/21 16:27

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DUP.FOR.INT_noodles12_Both-Hands_20.12.2021_MHS.jpg DUP.FOR.INT_noodles12_Both-Hands_20.12.2021_MHS.jpg (16x)

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DUP.FOR.INT_noodles12_Left-Hand_20.12.2021_MHS.jpg DUP.FOR.INT_noodles12_Left-Hand_20.12.2021_MHS.jpg (7x)

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possible   comparative   callouses   insufficient   experience   presentation   weightlifting   differential   uses-treatments   characteristic   predisposing   progression   osteoarthritis   noodles12   examination   contracture   PHOTOGRAPHS   CONSULTATION   potentially   clarification