Insights into the early phases of Dupuytren’s disease
Insights into the early phases of Dupuytren’s disease
Dupuytren’s disease is a condition in which nodules and cords in the palm can eventually cause the fingers to contract. As surgery often has limited long-term success and may lead to complications, this thesis of Roel van Straalen focuses on the early recognition and monitoring of the disease to prevent progression.
The thesis consisted of two parts: an analysis of the patient-journey within general practice and a study on the use of ultrasound to monitor disease progression. Data from dozens of GP practices in the northern Netherlands were used for the primary care analysis, while ultrasound data were obtained from a previous UMCG study.
Results showed that in 2021, almost 2% of people registered with a GP had Dupuytren’s disease, particularly men aged 61–80 years. The condition was usually recognised during the first consultation. Over an 18-year period, many patients had only one GP visit, typically reporting nodules without functional limitations. During follow-up visits, more patients reported daily activity impairments. GPs often adopted a watchful waiting approach, although referrals to specialists were also common. Many patients, however, remained under GP care.
Ultrasound proved to be a reliable tool for detecting early changes in the size and activity of Dupuytren nodules, provided the measurements were performed by the same examiner. These findings demonstrate that ultrasound can play a valuable role in the early detection and monitoring of Dupuytren’s disease and may support the use of future treatments aimed at preventing disease progression.