Dupuytren's contracture: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
[[File:Morbus dupuytren fcm.jpg|thumb|Dupuytren's contracture of the ring finger]] | [[File:Morbus dupuytren fcm.jpg|thumb|Dupuytren's contracture of the ring finger]] | ||
[[File:Dupuytren's2010.jpg|thumb|Dupuytren's contracture of the right little finger. Arrow marks the area of scarring]] | |||
*Initially, painless nodules are present longitudinally along the lines of tension | *Initially, painless nodules are present longitudinally along the lines of tension | ||
*Contracture deformities within fascial bands of the hand occur when the nodules form cords | *Contracture deformities within fascial bands of the hand occur when the nodules form cords | ||
Revision as of 20:38, 27 February 2021
Background
- Dupuytren's contracture is a progressive, permanent flexion of the digits of the hand due to myofibroblastic disease of the palmar and digital fascia
- It most commonly affects the fourth and fifth digits
- Unilateral contracture predominately affects the right side but bilateral involvement is common
Clinical Features
- Initially, painless nodules are present longitudinally along the lines of tension
- Contracture deformities within fascial bands of the hand occur when the nodules form cords
- Blanching of the digit on extension
- Proximal to the nodules, the cords are painless
- Pits and grooves may be present
- The knuckle pads over the PIP joints may be tender
- If the plantar fascia is involved, this indicates more severe disease (Ledderhose disease)
- The tabletop test (Hueston) is performed by having the patient attempt to place the palm flat on the exam table. If there is any flexion contracture deformity, the patient will be unable to straighten the fingers, resulting in a positive test.[1]
Differential Diagnosis
- Rheumatoid Arthritis
- Extensor tendon rupture
- Extensor tendon injury