Monday, January 31, 2011

Dupuytren's contracture Signs and symptoms

Dupuytren's contracture
Signs and symptoms
Mean age of onset in men is 50 years, the onset is delayed in women. The patient describes a feeling of tightening and firmly on the palm area, fingers or less. This thickening is often present for several years and may be slowly progressive. Ring finger is most commonly affected, followed by the little finger. The disease can be bilateral but is generally not symmetric in severity. The nodules are painless. Tenosynovitis can develop and lead to pain when the nodules are large. With progression of the disease may develop a flexion deformation. Patients unable to gather accusing fingers. Dupuytren's diathesis is observed in patients with onset at ages younger than 40 years with bilateral disease, family history of disease and ectopic lesions. They are considered risk factors for disease recurrence and extension. The disease may be associated with damage to the penis, Peyronie's disease, the disease-affected Ledderhose plantar fascia.
Physical examination. Depending on the stage of disease is seen more presentations to describe: Early stage: localized thickening of the palmar skin and subcutaneous tissue adjacent skin loss of mobility. Can this be a depression or a band supradenivelata the affected area. Nodular stage: initial nodes are palpable, they are visible late. Nodules are firm, fixed and well located. When the disease affects the palm, nodules are located in line with his chic little ring finger. Nodules are located on digital interphalangeal joint or the metacarpofalangiana. Stage band: the band is a similar linear thickening of the tendon. Progressive contraction of its cause deformation in flexion of the fingers. When deflection is 30 degrees you can not slap the patient lying on a flat surface.
Diagnosis. Dupuytren's contracture Signs and symptoms
The differential diagnosis is made with the following conditions: Callus, epithelioid sarcoma, galglionar cysts, stenosing tenosynovitis, tendon flexors Prolab, ulnar nerve palsy, camptodactilie, fibroids and fibromatoze.

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