Worried and uncertain (35yo, nodule in thumb) | Dupuytren | Forum for Dupuytren and Ledderhose Disease

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Worried and uncertain (35yo, nodule in thumb)
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09.04.20 16:20
hex 
09.04.20 16:20
hex 
Worried and uncertain (35yo, nodule in thumb)

Hi,

Seeking thoughts, experiences and advice.

A month ago I noticed small hard knot at the MCP joint of my left thumb ~2mm. I was worried it was bone growth, but in a very quick check my GP confirmed that it was the tendon. There were no tests besides physical examination of the knot/nodule. I had suggested early onset Dupuytren myself, which she said it could be but since I have no contraction they generally don't take action until it progresses here in Ontario. Only because it was my thumb she would consult a plastic surgeon (which I believe is common practice for Dupuytren's in Ontario). The surgeon responded that they would wait until there is pain or triggering of the finger and at that time they would refer for steroid injections. I have no contractions, and no pain (perhaps imagined sensations after the GP visit).

This has spiraled me into a sense of worry, and uncertainty. I've read a significant amount of research which I'm still processing to better understand what to expect, and I feel confused as I'm debating myself whether this is the right diagnosis.

I'm 35 years old, I have no family history of Dupuytren's, as of 2-3 years I rarely drink alcohol, my genetic inheritance is Iranian although I've lived in Scandinavia since I was a child, and just recently moved to Canada. The only potential confounding factor would be weightlifting exercises that I've done for over 15 years but only at an intermediate amateur level. However over the last 2-3 months before I noticed the knot I've been exclusively been doing semi-long distance (10km) running 2-3 times a week.

I'm seeking advice on how to get clarity on the diagnosis, what options are there to rule out other causes? Is there any way to assess if this is an old injury that has simply caused calcification of the tendon but was out of chance discovered now?

Assuming it is Dupuytren's, the outlook for young (<50yo) does not look very promising, anyone with experience of early onset, in particular of the thumb? What are reasonable actions to take at this stage?

Thank you for taking the time to read my story, and I appreciate all answers and perspectives!

Edited 09/04/20 17:18

09.04.20 18:39
spanishbuddha 

Administrator

09.04.20 18:39
spanishbuddha 

Administrator

Re: Worried and uncertain (35yo, nodule in thumb)

Hi hex, in your situation I would seek the advice, for a diagnosis, of an experienced hand surgeon, experienced in treating lots of DD, and not rely on that of a plastic surgeon. It's possible the surgeon would look for other risk factors, and your experience of symptoms other than just the 'lump', physical examination of the area, and may use ultrasound or x-ray to determine further the origin and cause of the lump. I myself have a ganglion in the palm on an MCP which could be confused by someone for a DD nodule, and I also have another lump on a finger dorsal MCP joint that is symptomatic of an arthritic injury, but there are different physical characteristics upon palpation in both cases compared to my DD nodules. We list a couple of Drs here https://www.dupuytren-online.info/NA_list_North_America.html

If it is DD then you can plan treatment options from there, including wait and see (active monitoring is better), steroid injections, RT, etc.

I would say, if it's pertinent, look after your hands when using weights, but continue.
Best wishes SB

09.05.20 11:05
wach 

Administrator

09.05.20 11:05
wach 

Administrator

Re: Worried and uncertain (35yo, nodule in thumb)

Prof. Heinrich Seegeschmiedt asked my to post for him:

I would be willing to have a Medical Video Consultation with „hex“ regarding a possible radiotherapy. To prepare for that hex could first email photos of the hand to me, prof.seegenschmiedt@gmail.com . I will return from vacation on September 14, 2020 and will then respond.

09.05.20 11:08
wach 

Administrator

09.05.20 11:08
wach 

Administrator

Re: Worried and uncertain (35yo, nodule in thumb)

Personal comment: I myself developed my first Dupuytren nodule at the age of 35. That is now nearly 40 years ago and I am still doing OK, so from my view tthere is no need to worry too much. Radiotherapy helped my to hold Dupuytren's at bay. My first nodule wnet away and never came back.

Wolfgang

07.19.22 13:00
Rebecca 
07.19.22 13:00
Rebecca 

Re: Worried and uncertain (35yo, nodule in thumb)

Rebecca :)
Diagnosed at 19/Female/Family History of Dupuytren

Hi! I hope you see this message because I am in a similar situation! I was diagnosed with DD (nodule in palm) in my late teens, and a few years later I developed a nodule in my thumb. Neither nodule is changing fast at all. Feel free to ask me any questions.

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