Exams and Tests

Dupuytren's disease develops slowly and may be hard to diagnose in its early stages. Most people do not see a doctor until the disease has progressed. A medical history and physical exam usually provide enough information for your doctor to determine whether you have Dupuytren's disease.

Questions about your medical history for Dupuytren's disease will usually include:

• Whether any close family members have been diagnosed with Dupuytren's disease or have had any similar symptoms.
• Your ethnic background.
• The symptoms and signs you've experienced and for how long.
• Whether you've noticed similar symptoms on the soles of your feet.
• Whether you've experienced any pain in your hand.
• Whether you have a history of smoking or alcoholism.
• Whether you have other medical conditions, such as diabetes, or if you are being treated for epilepsy.

A physical exam for Dupuytren's disease will usually include:

• Moving your hand and wrist in various positions.
• Moving your fingers to check for flexibility.
• Feeling the palm of your hand for a knot (nodule) or cord.
• Looking for any skin changes on your hand, such as dimpling or thickening on the palm.

Treatment Overview

The goal of treatment for Dupuytren's disease is to keep or restore hand function. Dupuytren's disease often is a progressive disease, and recurrence is common.

Initial treatment

Dupuytren's disease often develops slowly. If the tissue between your skin and tendons (palmar fascia) does not thicken to the point that your fingers are bent and cannot be straightened (contracture), you may only need to have your palms checked regularly.

In the early stages of the disease, you may be able to keep hand function by doing range-of-motion exercises. In some cases, splints are used to try to slow the progress of the disease. But there is not much evidence that stretching or splinting helps.

Ongoing treatment

Treatment for Dupuytren's disease depends on how bad the disease is. You may notice the characteristic nodules in your palms years before your condition interferes with daily activities, or you may never have a reduction in your range of motion.

A long-acting corticosteroid medicine is sometimes injected directly into the affected area to help manage symptoms of the disease in its early stages, before one or more fingers bends toward the palm (contracture).

Collagenase (such as Xiaflex) injected into the tight cord can help reduce the contracture and improve the range of motion.²

Treatment if the condition gets worse

In severe Dupuytren's disease, the tissue between your skin and tendons (palmar fascia) thickens to the point that your fingers are bent and cannot be straightened (contracture). If you lose the ability to wear gloves or hold objects, or if your hands become painful, a procedure may be done to relieve the contracture. Surgery is most common, but some doctors are now doing needle aponeurotomy.

In needle aponeurotomy (also called percutaneous needle fasciotomy), a local anesthetic is injected into the palm. A needle is used to put small holes in the tight cords. The fingers are then extended to separate the cords. A splint is used to keep the finger straight as it heals.

Surgery can restore mobility to your hands, but Dupuytren's disease recurs often and reoperation may be necessary to keep hand function. After surgery, a sustained program—including using splints, stretching, and doing scar tissue massage and hand exercises—may help you regain mobility and prevent complications or recurrences of the disease.³

What to think about

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