Dupuytren's Disease Flashcards
1
Q
ESSENCE
A
Fascia of hand becomes thickened and tight, leading to finger contractures
2
Q
What is a contracture
A
Shortening of soft tissues that leads to restricted movement in joint
3
Q
AETIOLOGY
Risk factors
A
- Age
- FH - autosomal dominant pattern
- Male
- Manual labour
- Diabetes
- Epilepsy
- Smoking
- Alcohol
4
Q
AETIOLOGY
Pathophysiology
A
- Palmar fascia forms triangle of strong connective tissue on palm
- Fascia becomes thicker and tighter and develops nodules
- Cords of dense connective tissue extend into fingers, pulling them into flexion and restricting their ability to extend (contracture)
- Unclear why fascia becomes thicker and tighter
5
Q
CLINICAL FEATURES
Presentation
A
- Hard nodules on palm - first sign
- Skin thickening and pitting
- Fingers pulled into flexion
- Thick, nodular cord can be palpated from palm into affected finger in later disease
6
Q
Which finger most and least likely to be affected
A
Most - ring finger
Least - index finger
7
Q
Special test
A
Table-top test
8
Q
What is table top test
A
- Patient tries to position hands flat on table
- If hand cannot rest completely flat, test is positive
