Dupuytren’s contracture – what are the signs and symptoms of Dupuytren’s contracture?

Dupuytren's contracture
Dupuytren’s contracture

Dupuytren’s contracture (Dupuytren’s disease) is a condition that affects the hands and fingers. It causes one or more fingers to bend into the palm of the hand. It can affect one or both hands, and sometimes affect the thumb.

Dupuytren’s contracture occurs when the connective tissue in the palm thickens. Often the tissue thickens in one small area first and a “nodule” forms (a small, hard lump about 0.5-1cm) under the skin of the palm. The nodule sometimes feels tender to begin with, but this usually passes. More nodules may then develop.

 The nodules are non-cancerous (benign) and the condition isn’t life-threatening for those who develop it, although it can be a nuisance to live with.

Over time, the nodules can extend and form cords of tissue. These cords can shorten (contract) and, if the cords run along a finger or thumb, they can pull it, so it becomes bent towards the palm. These contractures are often mild and painless, but they can get steadily worse over time.

Read more about the symptoms of Dupuytren’s contracture and diagnosing Dupuytren’s contracture.

Why it happens

The exact cause of Dupuytren’s contracture is unknown, but it’s thought to be related to your genes, as it often runs in families.

If you have the gene that causes Dupuytren’s contracture, other factors such as diabetes, smoking and certain medications (for example, medication for epilepsy) may activate the condition. However, it’s not clear how significant these factors are.

Read more about the causes of Dupuytren’s contracture.

Who’s affected

Dupuytren’s contracture is fairly common. It can affect both sexes, but affects men more than women. The condition usually occurs during later life, although cases have been reported in children. Most cases occur in men over 50 and women over 60.

The condition seems to be more common in people of North European descent. It’s thought the gene associated with the condition was brought to the UK by the Vikings.

Preventing Dupuytren’s contracture

As the exact cause of Dupuytren’s contracture is unknown, it may not be possible to prevent the condition.

However, if you’re at risk of developing the condition – for example, if you’ve had it in the past, or if you have a family history of it – stopping smoking (if you smoke) may reduce your risk.

Treating Dupuytren’s contracture

Many cases of Dupuytren’s contracture are mild and don’t need treatment. Treatment may be helpful if the condition is interfering with the normal functioning of your hand.

Non-surgical treatments include radiation therapy and injections with a medication called collagenase.

Alternatively, a minor procedure that involves using a needle to cut the contracted cord of tissue (needle fasciotomy) may be used in the early stages of the condition.

In more severe cases, surgery can help to restore hand function. The two most common surgical techniques are:

open fasciotomy – where the shortened connective tissue is cut to relieve tension

fasciectomy – where the shortened connective tissue is removed

Surgery for Dupuytren’s contracture can’t always fully straighten the affected finger or thumb, and the contracture can recur after surgery. If a contracture does recur, further surgery may be possible.

Having surgery to remove the first nodule that appears won’t stop the condition from progressing, as this won’t stop the condition occurring elsewhere in the palm. It’s usually best to avoid surgery until a contracture develops that interferes with use of the hand.

Read more about treating Dupuytren’s contracture and recovering from Dupuytren’s contracture surgery.

Ongoing research

Some other treatments have been suggested for Dupuytren’s contracture, but there’s currently not enough medical evidence to support their use.

For example, the National Institute for Health and Care Excellence (NICE) doesn’t recommend the use of vitamin E cream or ultrasonic therapy. Trials into other possible treatments are under way.

Dupuytren’s contracture often runs in families and genetic research hopes to identify the genes responsible for the condition. This could lead to the development of treatments that prevent contractures occurring in the first place.

November is National Epilepsy Awareness Month #NEAM2016 – please like and share this awareness meme!

 November is National Epilepsy Awareness Month
November is National Epilepsy Awareness Month

November is National Epilepsy Awareness Month. We have produced this meme to help raise epilepsy awareness. It would be great if you could like and share to help awareness. And please do use #NEAM2016 as a hashtag.

As many of you know epilepsy is very common in the autism community so sharing awareness is very important for those who have autism spectrum condition.

For more information please have look at our previous informational blogs on the subject of epilepsy!

Attention deficit hyperactivity disorder – Signs and Symptoms of ADHD

The sign and symptoms of ADHD
The sign and symptoms of ADHD

The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorised into two types of behavioural problems.

These categories are:

hyperactivity and impulsiveness
inattentiveness

Most people with ADHD have problems that fall into both these categories, but this isn’t always the case.

For example, some people with the condition may have problems with inattentiveness, but not with hyperactivity or impulsiveness. This form of ADHD is also known as attention deficit disorder (ADD). ADD can sometimes go unnoticed because the symptoms may be less obvious.

Symptoms in children and teenagers

The symptoms of ADHD in children and teenagers are well defined, and they’re usually noticeable before the age of six. They occur in more than one situation, such as at home and at school.

The main signs of each behavioural problem are detailed below.

Inattentiveness

The main signs of inattentiveness are:

having a short attention span and being easily distracted
making careless mistakes – for example, in schoolwork
appearing forgetful or losing things
being unable to stick at tasks that are tedious or time-consuming
appearing to be unable to listen to or carry out instructions
constantly changing activity or task
having difficulty organising tasks

Hyperactivity and impulsiveness

The main signs of hyperactivity and impulsiveness are:

being unable to sit still, especially in calm or quiet surroundings
constantly fidgeting
being unable to concentrate on tasks
excessive physical movement
excessive talking
being unable to wait their turn
acting without thinking
interrupting conversations
little or no sense of danger

These symptoms can cause significant problems in a child’s life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline.

Related conditions in children and teenagers

Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as:

anxiety disorder – which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness
oppositional defiant disorder (ODD) – this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers
conduct disorder – this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals
depression
sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns
autistic spectrum disorder (ASD) – this affects social interaction, communication, interests and behaviour
epilepsy – a condition that affects the brain and causes repeated fits or seizures
Tourette’s syndrome – a condition of the nervous system, characterised by a combination of involuntary noises and movements called tics
learning difficulties – such as dyslexia

Symptoms in adults

In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD.

ADHD is a developmental disorder; it’s believed that it can’t develop in adults without it first appearing during childhood. But it’s known that symptoms of ADHD often persist from childhood into a person’s teenage years, and then adulthood.

Any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, may also continue into adulthood.

By the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives.

The symptoms in children and teenagers, which are listed above, is sometimes also applied to adults with possible ADHD. But some specialists say that the way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children.

For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms.

Some specialists have suggested the following list of symptoms associated with ADHD in adults:

carelessness and lack of attention to detail
continually starting new tasks before finishing old ones
poor organisational skills
inability to focus or prioritise
continually losing or misplacing things
forgetfulness
restlessness and edginess
difficulty keeping quiet and speaking out of turn
blurting out responses and often interrupting others
mood swings, irritability and a quick temper
inability to deal with stress
extreme impatience
taking risks in activities, often with little or no regard for personal safety or the safety of others – for example, driving dangerously




Additional problems in adults with ADHD

As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions.

One of the most common conditions is depression. Other conditions that adults may have alongside ADHD include:

personality disorders – conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others
bipolar disorder – a condition that affects your moods, which can swing from one extreme to another
obsessive-compulsive disorder (OCD) – a condition that causes obsessive thoughts and compulsive behaviour

The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships, social interaction, drugs and crime. Some adults with ADHD find it hard to find and stay in a job.