Dupuytren's: Questions for and From Your Doctor
If you or a loved one has symptoms of Dupuytren's contracture, also known as Dupuytren's disease, it's important to see a health professional for a definitive diagnosis. Your health care provider can also answer your questions about Dupuytren's, including what to expect, and available treatment options.
Questions Your Health Care Provider May Ask
When you see your health care provider, he or she will likely ask you the following questions:
- What are your symptoms, and when did you first detect them?
Try to provide as much detail as possible, as this information will help your doctor evaluate the severity of your condition and its rate of progression.
- Is there pain associated with your symptoms?
Dupuytren's contracture is generally painless, although the lumps or nodules that appear on the palm of the hand may be tender to the touch.
- Have any of your relatives received a Dupuytren's diagnosis or had symptoms of Dupuytren's?
Since Dupuytren's disease runs in families, this is likely to be one of your doctor's first questions.
- What is your family ancestry?
Your health care provider will likely ask about your family heritage, since Dupuytren's contracture is most common in people of Northern European and Scandinavian descent.
- Do you have diabetes or a seizure disorder?
For reasons that are not fully understood, Dupuytren's contracture is often associated with both these medical conditions.
- Do your symptoms affect your daily activities, and if so, how?
Have your symptoms made it harder to shake hands, garden, or conduct other routine activities?
- Can you do the “table-top test”?
Doctors can often make a diagnosis through a physical exam. X-rays or an MRI are usually not necessary. Your doctor is likely to ask you to do the "table-top test." As its name suggests, you will be asked to place your palm on a table. If you have Dupuytren's, you will not be able to lay the palm flat. This test, along with other measurements, is used to evaluate the degree of contracture in your fingers, and to monitor your condition over time.
After reaching a diagnosis, your health care provider will provide general information on Dupuytren's disease, including what you can expect and possible treatment options. You may want to prepare a list of questions ahead of time to take with you. Bring a notebook and pen so that you can record the details.
Possible questions to ask your health care provider include:
- How fast will the disease progress?
The rate at which Dupuytren's progresses is highly variable, so your doctor won't be able to give you an exact timeline. In most cases, the disorder develops slowly, over the course of months and years. In rare cases, however, symptoms develop in a matter of weeks and months. Your health care provider may be able to make an estimate based on how your symptoms have developed to date.
- How often should you see your doctor for follow-up evaluations?
If your symptoms are relatively minor and are not impeding your daily activates, your physician will likely recommend that you delay treatment. If this is the case, she will likely recommend that you self-monitor your symptoms and come in regularly for re-evaluations.
- What are the treatment options?
The treatment you receive will depend on the location, stage, and severity of the disorder. In your initial consultation, your doctor will probably provide a brief overview of how Dupuytren's is treated. A newer procedure uses enzyme injections to dissolve the tissue. This is usually used first as it is least invasive. In cases where contracture has progressed, surgery is the most common treatment. Another treatment method uses needles to break up affected tissue.
- Will symptoms recur?
As mentioned earlier, the recurrence rate of Dupuytren's symptoms is high, so whatever treatment you have may need to be repeated. Recurrence rates are lower after surgery than after needle or enzyme procedures.
- Dupuytren's support and information.
Ask your doctor about online and local Dupuytren's resources, including patient communities. Other people who deal with Dupuytren's can provide an ongoing source of information and support.