Knuckle Pads (Garrod’s Nodules) of the Fingers: Painful Dorsal Nodules on the PIP Joints of the Fingers and Concomitant Recurrent Dupuytren’s Contracture

200 consecutive geriatric patients over 60 years of age (100 men and 100 women) were examined for signs of Dupuytren’s contracture and questioned about certain risk factors thought to be associated with the disease. Each patient was examined, independently, by two orthopaedic surgeons. The diagnosis of Dupuytren’s contracture was established by the finding of a thickening in the palm fixed to the palmar fascia as a nodule or band. However each patient was also examined for skin tethering, flexion contractures of digits and knuckle pads. The results were then analysed and a Kappa test performed on the data to assess the inter-observer variability in eliciting the signs of Dupuytren’s contracture. Using the Kappa test agreement between the two observers was found to be, on average, 1.0 for observing flexion contractures, 0.8 for observing skin tethering, 0.7 for observing palmar nodules and 0.7 for observing knuckle pads. The two observers both made the diagnosis of Dupuytren’s contracture in 21% of women and 39% of men. These figures are high compared with previously published data from other centres and confirm the locally held belief that Dupuytren’s contracture is particularly prevalent in North-east Scotland.

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Erosive Arthritis, Fibromatosis, and Keloids: A Rare Dermatoarthropathy

Case Reports in Rheumatology ◽

10.1155/2018/3893846 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Fawad Aslam ◽

Jonathan A. Flug ◽

Yousif Yonan ◽

Shelley S. Noland

Keyword(s):

Rare Disease ◽

Peyronie’S Disease ◽

Dupuytren’S Contracture ◽

Erosive Arthritis ◽

Dupuytren's Contracture ◽

Rare Syndrome ◽

Knuckle Pads ◽

Peyronie's Disease ◽

Plantar Fibromatosis ◽

Palmar Fibromatosis

Polyfibromatosis is a rare disease characterized by fibrosis manifesting in different locations. It is commonly characterized by palmar fibromatosis (Dupuytren’s contracture) in variable combinations with plantar fibromatosis (Ledderhose’s disease), penile fibromatosis (Peyronie’s disease), knuckle pads, and keloids. There are only three reported cases of polyfibromatosis and keloids with erosive arthritis. We report one such case and review the existing literature on this rare syndrome.

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Dupuytren's Contracture and Microvessels

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100098848 ◽

1981 ◽

Vol 39 ◽

pp. 470-471

Author(s):

C. W. Klscher ◽

D. Speer

Keyword(s):

Hypertrophic Scar ◽

Active Form ◽

Scar Tissue ◽

Vascular Supply ◽

Fiber Bundles ◽

Dupuytren’S Contracture ◽

Palmar Fascia ◽

Immune Disease ◽

Dupuytren's Contracture ◽

Longitudinal Fiber

Dupuytren's Contracture is a nodular proliferation of the longitudinal fiber bundles of palmar fascia with its attendant contraction. The factors attributed to its etiology have included trauma, diabetes, alcoholism, arthritis, and auto-immune disease. The tissue has been observed by electron microscopy and found to contain myofibroblasts.Dupuytren's Contracture constitutes a scar, and as such, excessive collagen can be observed, along with an active form of fibroblast.Previous studies of the hypertrophic scar have led us to propose that integral in the initiation and sustenance of scar tissue is a profusion of microvascular regeneration, much of which becomes and remains occluded producing a hypoxia which stimulates fibroblast synthesis. Thus, when considering a study of Dupuytren's Contracture, we predicted finding occluded microvessels at or near the fascial scarring focus.Three cases of Dupuytren's Contracture yielded similar specimens, which were fixed in Karnovskys fluid for 2 to 20 days. Upon removal of the contracture bands care was taken to include the contiguous fatty and areolar tissue which contain the vascular supply and to identify the junctional area between old and new fascia.

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