Hi, I'm a 35 year old female and I have been having problems with my hands for about a year and a half now. Mainly stiffness of the fingers at night and in the mornings, and mainly my ringfinger and pinky. They seem to want to bend inwards. Both hands are affected, although mostly left (right is my dominant hand). I have a strong feeling my hands are changing, also the tissue in the palm of my hands. Most of the time, I cannot wear my rings, because my knuckles seem to be swollen. Also, on the sole of my left foot, there's a lump (quite painless). I can still put both hands flat on the table.
I have seen 5 doctors about this: my GP, who thought it was Carpal Tunnel and referred me to a physiotherapist. That was about 4 months ago. He did an EMG on me, but there was nothing wrong with my nerves. He hardly looked at my hands and when I asked whether it could be Dupuytren's, he said it probably was but said there was nothing to worry about. On the same day, another doctor did an echo of the lump on my foot and said: I don't know what it is. I asked my GP if I could see a specialist in another hospital as I wasn't very happy about the one I went to. She referred me to a plastic surgeon.
The plastic surgeon had a look and said he didn't know what it was. He said: maybe an inflammation of the tendon sheaths. But as he wasn't sure, he sent me to a colleague, who was a neurologist (under training!) and she didn't know at all what do to with me. So I left the hospital, again not very wiser.
Now, several months later, the problems are worsening. I can see and feel cords in my left hand (or are they tensed up tendons?) and in my right hand, I can clearly feel two small lumps. Also the tendon leading from my wrist to the palm of my left hand seems to be permanently tensed up. I know Dupuytren's has got nothing to do with tendons, by the way.
I am worrying a lot, as I am still relatively young and my hands seem to be changing quite rapidly. Where is this leading to? I feel hesitant about going to my GP again, asking for another referral. I've included a couple of pictures of my hands. I know it's impossible to make a diagnosis on the internet, but I would like to have your opinion. You know what the disease is like, and I have a feeling all the doctors/specialists I've seen so far were not very familiar with the disease.
By the way, my grandfather had Dupuytren's (at a late age), my uncle has a triger finger and my mum has sclerodermia (an autoimmune disease which affects the connective tissue. She also has a lot of hand problems).
It sounds like Dupuytrens, but does not really look like it. Honestly, you deserve the opinion of an expert. You should really see an orthopedic surgeon-hand specialist. Good Luck, Fjellver
I tend to agree with fjellver. From your family history and your description it is likely Dupuytren's but your pictures don't show any cords. Could you possibly make a picture with your hand fully straight or even over-stretched? Then potential nodules/cords might be easier to see.
I guess you are living in the UK. If so, you might check the website of the British Dupuytren's Society for addresses of experts in Dupuytren's http://www.dupuytrens-society.org.uk/.
Have you been to a rheumatologist (RD)? There are some kinds of arthritis that are not bilateral, (like bilateral rheumatoid arthritis) which can affect only one hand or the other. Finger swelling and pain could be psoriatic arthritis (PA), which is what I have, and I don't have psoriasis. I had gone to numerous docs when my hands were in awful pain, maybe similar to what you're describing, including RDs. One dismissed my finger and hand pain, saying it was "just" tendinitis. I said, "It's not tendinitis!!", rather loudly. I never when back. The RD I finally got to suggested PA, which has been my diagnosis ever since, and being treated accordingly with Enbrel. I also had intermittent severe hip pain, which helped that diagnosis. But, he was also the doctor that first diagnosed my Dupuytren's disease. He really was an amazing doctor, and I owe him the world. But, he died a few years ago from kidney cancer. But, I digress....
Anyway, I suggest you see a RD, if you haven't already. They specialize in joint diseases, odd inflammations, etc. And, you should know that just because you do not have a positive rheumatoid factor in your bloodwork does not mean you don't have arthritis. A good doc knows that and won't blow you off.
Thank you very much for your quick answers! There are definitely NO very clear cords or lumps to be seen on my hands, but I do feel something changing, a thickening or tensing up. In the palm of my left hand, a bit underneath my index and ring finger, there's two little bumps, that look a bit yellowish (like callous) and that weren't there before. The thumb pad of my right hand seems slightly swollen. I can fully stretch both hands, but I do feel some sort of resistance. In the mornings, my ring finger and pinky are curled inwards, although I can stretch them back into position. My foot shows a clear lump though, it's been there as long as my hands are troubling me, around one and a half years.
I am confused because I keep on thinking of Dupuytren's and wondering whether I should jump into action, now that it's still in an early stage. Then again, it's true what you say: some things are typically of Dupuytren's, others aren't. Maybe it's nothing serious. I don't want to panic and worry all the time, but I can't help it. It's my hands, after all!
I live in Belgium, by the way, very near to the Netherlands.
zinkadoodle:Have you been to a rheumatologist (RD)? There are some kinds of arthritis that are not bilateral, (like bilateral rheumatoid arthritis) which can affect only one hand or the other. Finger swelling and pain could be psoriatic arthritis (PA), which is what I have, and I don't have psoriasis. I had gone to numerous docs when my hands were in awful pain, maybe similar to what you're describing, including RDs. One dismissed my finger and hand pain, saying it was "just" tendinitis. I said, "It's not tendinitis!!", rather loudly. I never when back. The RD I finally got to suggested PA, which has been my diagnosis ever since, and being treated accordingly with Enbrel. I also had intermittent severe hip pain, which helped that diagnosis. But, he was also the doctor that first diagnosed my Dupuytren's disease. He really was an amazing doctor, and I owe him the world. But, he died a few years ago from kidney cancer. But, I digress....
Anyway, I suggest you see a RD, if you haven't already. They specialize in joint diseases, odd inflammations, etc. And, you should know that just because you do not have a positive rheumatoid factor in your bloodwork does not mean you don't have arthritis. A good doc knows that and won't blow you off.
Good luck. I hope I was helpful.
Hi Zinkadoodle,
Thanks for your answer! So, do you have both PA and Dupuytren's then? I actually do have a lot of hip pain as well (and back and neck pain). I will maybe try and go see a rheumatologist. My mum goes to good one, I'll ask her. Thanks a lot for your advice! Lina
Thanks for your answer! So, do you have both PA and Dupuytren's then? I actually do have a lot of hip pain as well (and back and neck pain). I will maybe try and go see a rheumatologist. My mum goes to good one, I'll ask her. Thanks a lot for your advice! Lina ~~~~~~~~~~~~~~~~~
Yes, Lina, I do have both PA and DC. And, they really do manifest as very different diseases. I just happened to find a good doc who recognized both and got treated accordingly for both. He gave me my life back. But, it did take a lot of mucking around with lousy docs before I found him. As my father used to say, "There is always some doctor somewhere who graduated at the bottom of his class." The challenge is sorting through these jerks.
1) You are quite a ways from having to worry about this if it is Dupuytren's. "They" didn't tell you much because it would be a leap to have a for sure diagnosis at your very early stage. Watch it and be ready to decide if the first step for you is RT in the future.
The right hand picture looks like the start of two nodules (the discolored callus like areas), but that is a guess at this time. This might not progress any further for decades. Or, the nodules might develop.
Thanks all, for your comments...I just wonder...when and how will I be sure that it is Dupuytren's? And if it does turn out to be Dupuytren's, when is the right time to start RT-treatment? That is what keeps worrying me a bit, although I'll try not to think about it too much...
Obviously, it's a judgment call, and one related to your comfort level. I know a woman who has pronounced Dupuytren's nodules on both hands, she says they've been that way for 25 years, but her fingers never contracted. So, she does nothing at this point. The nodules don't bother her. I have nodules on my left hand and a cord that runs up my thumb that formed after my OS done over 10 years ago. They've never caused me any problems, no contractures, nothing, so I ignore them. My feeling is, if it ain't broke, don't fix it.
My right hand is a different story, and now that the contractures are hanging me up, I'm dealing with it. I see the surgeon on Monday, and will get Xiaflex probably the following week.
I'm not sure what to tell you. If just having the nodules bothers you, get RT just to be on the safe side. I never did, because I never knew about it. Am I going to get RT on my left hand? Probably not. I'll see what the doc says. But again, it's been that way for 10 years with absolutely no progression. It's a comfort level, based not only on the physical condition, but also the psychological effects of having it. We're all different.
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The challenge is sorting through these jerks.
