Dupuytren Disease: Overview

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This video will provide an overview of Dupuytren disease, a condition impacting the connective tissue of the hands. Dupuytren disease is named for Guillaume Dupuytren, a French surgeon who notably studied the condition in the 1800s. Dupuytren disease falls into the bucket of connective tissue disorders. Connective tissue disorders can occur in many areas of the body and are often the result of overproduction of these tissues. Connective tissue has many functions. One function is helping bind tissues together.

As the tissue is overproduced, it contracts or tightens, leading to progressive loss of function of the structures in which it attaches. In Dupuytren disease, collagen, a protein found in the hands' connective tissue, is overproduced. This leads to noticeable nodules and cords in the palm and fingers that can cause contracture or tightening of the tissues. Over time, this abnormal tightening can lead to the fingers and palm curling. Approximately 8% of the population has Dupuytren disease, and roughly a third of those have dysfunction because of the condition.

It most impacts men over the age of 50, who are 3 to 4 times more likely than women to be affected. Dupuytren disease is primarily the result of genetic factors and often runs in families. Other factors can contribute to this condition, such as work exposures like long-term use of vibrating machinery. Excessive alcohol intake and diabetes have also been associated with the condition. The condition gradually progresses over time. However, the time of progression differs between all patients.

Patients may note a nodule in the palm and no other symptoms in early disease. As the disease progresses, patients may notice more prominent cords in the palm with curling of the fingers and decreased range of motion. Often, this is more prominent in the ring and pinky fingers. Pain and difficulty using the hand may be seen. These are important symptoms to discuss with the health care team as they may guide treatment decisions.

The diagnosis of this condition is usually made clinically, meaning no special tests or imaging are warranted. Often, the health care provider can diagnose through examination simply by feeling for nodules or chords in the palm, or looking for changes in the skin. One simple test that may be performed is the tabletop test. The palm or fingers cannot rest flat against the table in more advanced stages of the condition. This helps the health care team identify the severity and portions of the hand that may be impacted.

Given that the condition can occur in other connective tissues in the body, a health care provider may look for different areas of involvement, such as the plantar fascia of the feet. In summary, Dupuytren disease is a progressive condition and characterized by the overproduction of connective tissue on the palm side of the hand. It is more common in men and is often genetic. Cords and nodules are present in the hand. The diagnosis is typically made with examination alone.