Talk:Dupuytren's contracture/Archive 1

UK NICE Guidelines
"In the UK NICE published guidelines and approval in November 2010. The guidance which proposes only one phase of 15Gy (grays) of treatment as standard for non severe cases, would be ineffective and would provide only half the treatment required to stop Dupuytren's progression.[18]"

I don't see any evidence supporting the idea that 15Gy of radiation is ineffective, this appears to be the opinion of the wikipedia author alone based on the discrepancy between the trial dosage of 21Gy-30Gy and the recommended NICE guidelines dosage of 15Gy. To the best of my knowledge this dosage was recommended based on the potential for severe radiation side effects with high doses of radiation. Unless the wikipedia author is a trained radiologist, this opinion is out of place. Further, if the author is such a specialist, this opinion should be published in a peer-reviewd journal and then cited here.

I am changing this section to simply state that the UK approved the treatment, although in all honesty, I am not sure how relevant that is, wikipedia is a global encyclopedia, it is odd that the regulatory status of an intervention in a single country is listed at all.

Mike Dacre (talk) 16:19, 11 May 2014 (UTC)

I think it is useful as a point for comparison and region has a great bearing on the disease. Bwtranch (talk) 16:51, 11 May 2014 (UTC)

A
A relatively non-invasive form of surgery which has proved highly successful over the last decade or so is needle aponeurotomy. Developed in Paris, France, it now has a growing number of practitioners world-wide. It is not yet available in the UK, although the procedure was approved by NICE, the national body for clinical matters, in February 2004.

A summary of the treatment and a list of practitioners is available here: http://www.dupuytren.org/html/gbsommaire.html

Merge
I suggest just delete the article "Morbus Dupuytren". The overlap is total.--Anthony.bradbury 22:33, 11 August 2006 (UTC)

Morbus Dupuytren is the medical name for Dupuytren's contracture. Maintaining redundant articles probably doesn't make sense yet if we merge them, we ought to keep "Morbus Dupuytren" with a link to the "Dupuytren's contracture" article. Many people will search for morbus Dupuytren. --- Wolfgang

Although it's not common - the thumb, index finger or both can be involved and require correction. -- Jim H Confirmed, this is the version of the condition, thumb & index finger, I suffer from -- Matt D —Preceding unsigned comment added by 94.2.108.140 (talk) 23:58, 28 February 2010 (UTC)

Also, relatively uncommon, the soles of the feet can have the same process happening. Thankfully, orthotics can be made to take the pressure off of the painful lumps -- Ann A.  —Preceding unsigned comment added by A2922no70 (talk • contribs) 10:03, 2 October 2008 (UTC)

Possibly someone could add the pronunciation of the name? Soczyczi 00:48, 3 March 2007 (UTC)

My surgeon calls it Doopies. The original French would sound like Dur-PWEE-Tre(n) I think. Greglocock 01:31, 19 March 2007 (UTC)

Not much. What is "Viking descent" supposed to mean? Deipnosophista (talk) 21:21, 17 January 2008 (UTC)

"Viking Descent" means Northern European. -- Ann A. —Preceding unsigned comment added by A2922no70 (talk • contribs) 10:05, 2 October 2008 (UTC)

Singer, Frank Sinatra, reportedly from beating people?
That seems fairly slanderous, not to mention it's completely unsubstantiated and not a NPOV. 68.225.171.64 (talk) 12:38, 13 August 2011 (UTC)

contradictions
Under Risk factors and possible causes, the third bullet point reads "Rock climbers or manual labourers, associated with constant stress and micro-traumas of the tendons when climbing or absorbing shock through heavy blows of sledgehammers, jackhammers, spud bars, etc. Many younger climbers (under 26) were mis-diagnosed as having malignant tumors" while the subsequent paragraph says "There is no proven evidence that hand injuries or specific occupational exposures lead to a higher risk of developing Dupuytren’s contracture, although there is some speculation that Dupuytren's may be caused by, or at least the onset may be triggered by, physical trauma such as manual labor or other over-exertion of the hands. However, the fact that Dupuytren's is not connected with handedness casts some doubt on this claim.". These two statements are contradictory. I've tagged the former as citation-needed, since the latter is cited. --rahaeli (talk) 06:07, 19 October 2011 (UTC)
 * I have deleted the bullet point claiming that manual labourers and rock climbers are at risk. There is no evidence, and in any case it is covered by the later statement that "Some suspected, but unproven, causes of Dupuytren's contracture include trauma ..." SNALWIBMA ( talk - contribs ) 06:19, 19 October 2011 (UTC)
 * excellent -- that's what i was tempted to do, but since I'm a drive-by WikiSloth I figured I'd bring it up for discussion first :) --rahaeli (talk) 08:14, 19 October 2011 (UTC)

Eh, I don't know diligent in looking for sources you guys were, but removal of this information was incorrect. There are dozens of studies correlating DC to manual labor occupations which actually paraphrase the exact language used in the article Source 1 Source 2 and even a study on rock climbing: "It was revealed that 19.5% of male climbers had developed Dupuytren’s disease. There was a significantly higher life time intensity of climbing activity in those with the disease. An earlier age of onset of the disease was found in climbers compared with the general population." Source 3. I am unfamiliar with citing medical studies, but I will be re-adding these facts with citations when I get a moment. CompliantDrone (talk) 17:30, 8 March 2013 (UTC)

Recent rewrite
I refer to the series of rewrites by User:NHaenen that began with this edit. I'm sorry, but there are so many problems with this - mispunctuation, poor grammar, misformatted references, incorrect information, etc, etc. I started trying to correct it - but I think it might be best to go back to this version and try to work in the good parts of the new version from that point on. Any comments? In particular, would User:NHaenen like to comment? SNALWIBMA ( talk - contribs ) 15:14, 26 October 2011 (UTC)
 * I agree with the revert. Among the problems you've not mentioned is the big one of making it less easy to understand, by replacing comprehensible language with medical jargon. There's no need to dumb down, but Wikipedia isn't a medical textbook either. Incidentally, have you notified NHaenen of this discussion on this talk page? One last point - the problems that have arisen here are the type of problem you get when a single editor does a lot of work on an article using a sandbox and then applies them in one lump. Incremental editing at the article with helpful edit summaries does a lot to aid collegiate editing, which is what Wikipedia is about. --Dweller (talk) 15:25, 26 October 2011 (UTC)

I would like to comment on this. I am a student from Rotterdam and I had the assignment, together with another student, to add information (especially about the different treatment options) to this page. We never worked with Wikipedia before, so especially the references were a bit of a challenge. We are looking at that again now, but I was wondering what incorrect information you were referring to? Thanks for your reply. NHaenen — Preceding unsigned comment added by NHaenen (talk • contribs) 15:33, 26 October 2011 (UTC)
 * Sorry - perhaps I should not have said "inaccurate information", but I find it so hard to read it is in fact difficult to tell. The new version has some good points - such as (1) the classification of different treatments as surgical, minimally invasive (though this should be subsection of surgical) and medical, and (2) the inclusion of a section on recurrence - but it is so long, so badly written, so ungrammatical, that it is not an overall improvement. Sorry to be so harsh, NHaenen, and especially so if your first language is not English, but your text needs a lot of editing. It should probably be cut to about half its present length. It needs to be written in plain English, not in quasi-medical jargon that looks as if it has been dumped in from various sources on the web (abstracts of papers, etc.). A few specific points: (1) The material on the "table-top test" is far too long, and could be reduced to a few words (e.g. "Someone with Dupuytren's contracture is typically unable to place his or her hand flat, palm down, on a flat surface"). (2) Why has the word "aponeurosis" been deleted from the lead paragraph? Only if it is there do the later references to aponeurotomy make sense. (3) The recurrence section seems to be largely a somewhat mangled copy from the abstract of the 2006 paper by Hindocha et al. In an abstract in a medical journal phrases like "The term diathesis relates to certain features of Dupuytren's disease and dictates an aggressive course of disease" make sense; in a WP article they do not. It is also probably a breach of copyright: see WP:COPYVIO. (4) The format of references needs to be sorted out, and there are two broken references. (5) The text badly needs copy-editing, to make it consistent and amend the poor grammar - a lot of it is very poor English. Dweller makes a good point above - it would be far better to introduce this new material piece by piece, in a collaborative fashion, rather than dropping it all in at once. For example, faced with the whole thing as it is now, I do not have time to do the editing that is necessary - but I might have time to help someone who was making changes a step at a time. I think that would also be a better way for a new editor to learn how to work in Wikipedia. SNALWIBMA ( talk - <b style="color:#2F4F4F;">contribs</b> ) 06:11, 27 October 2011 (UTC)

Thanks for your reply. I must say, we found it very hard to make it understandable, when the only sources we were allowed to use were articles from medical journals. Especially beacause we are medical students, it is hard to determine when it is understandable for everyone. We thought it should be understandable, but i find it important to hear so if it is not. We are still working to get photos of the different techniques, but it is taking some time beacause we need the specific consent from the patients to use the pictures for Wikipedia. Maybe that would help to make it more understandable. Our assignment was to add a lot of information, but it was not clear for us it should be better to make the changes one step at a time. I would like to take a look at the problems and try solve them. About the references: What is the correct format? And are the two references still broken? (I thought I solved that problem yesterday, but if I have not I would like to hear) — Preceding unsigned comment added by NHaenen (talk • contribs) 08:00, 27 October 2011 (UTC)


 * note, NHaenen was a student who did this as part of a class. See contribs and this placing of a tag, now removed. Jytdog (talk) 00:50, 4 June 2017 (UTC)

Cure
In some cases, I have been told, sufferers have been cured by putting a finger into a tube and then putting a wedge into the tube on the palmside. Applied nightly for a period. I can't find a reference or source. Kittybrewster  &#9742;  12:19, 11 December 2011 (UTC)

'Bold text''

the etiology is at upper arm: Triceps and Deltoids muscles, base on old Chinese med, those muscles have been hit by 'evil wind',which cause them in spasm.Release the muscles spasm recirculate Chi will release spasm, also increase Chi flows to the hand/fingers. any problem on wrist and hand/fingers, all should treat the two muscles first. 20 yrs clinic exp.

Notable sufferers
I am interested if the evidence for John Hawkins as a sufferer can be shared and/or cited please? Olorin3k (talk) 11:33, 28 May 2012 (UTC)

Article title
According to the textbook I currently read (in Slovene, ISBN 961-6105-04-3), the disease is more properly called 'Dupuytren's disease' than 'Dupuytren's contracture', because (as explained in the article) it affects not only palms, but also other body parts (soles, penis, etc.) I think that the article should be moved to this more comprehensive title. --Eleassar my talk 17:10, 23 June 2012 (UTC)

amputation as treatment?
The article mentions this as an alternative, but gives no details. I suffer from Dupuytren's, or at least I did until hand surgery last week. Now I suffer from a painful and mostly useless hand. I didn't know amputating the affected finger was a possible alternative, and I really wish I had known about that possibility before the surgery. I could live without the finger; I can't live with a useless hand. 107.9.45.143 (talk) 21:30, 15 December 2013 (UTC)

MEDMOS
This article does not conform to WP:MEDMOS and should be revised accordingly. Lfstevens (talk) 23:09, 28 April 2015 (UTC)

In what way does it not conform? Bwtranch (talk) — Preceding undated comment added 23:52, 28 April 2015 (UTC)

On publication dates by Dupuytren
So the contracture was not described in the Lancet in 1831, as this and Guillaume Dupuytren had previously stated. He performed the operation in 1831, published it in the Lancet in 1834, and then in a Hôtel-Dieu de Paris publication posthumously in 1836 (he died in 1835). Cburnett (talk) 17:53, 13 March 2016 (UTC)

Risk factors
The statement that Dupuytren's is 'ten times commoner in men' does not appear to the true. The Netherlands study found a female:male ratio of 1:1.2. They quote other studies giving ratios of 1:3.8 to 1:1.5. I have therefore deleted this statement. - It is surprising that neither the Dutch study of 2013 nor the Reykjavik study of 2000 are mentioned here. I have added them. Kanjuzi (talk) 09:35, 5 June 2016 (UTC)

Introduction
There seems to be proliferation of names in the introduction. I would delete 'Viking disease' here (it is mentioned lower down, which should be sufficient) as it is not a common or official designation. I would also delete 'palmar fibromatosis'; that is not a name usually given to the disease, and it leads to the illogicality of saying that 'palmar fibromatosis is a contracture due to palmar fibromatosis'. I would also delete 'morbus Dupuytren'; this is a German name, not English, and if you Google it you will get articles in German. - Further, I would delete or modify 'inherited' disorder, since according to Dr Charles Eaton there is one type (namely that associated with diabetes) which is not inherited. - The name 'Dupuytren's disease' is not quite a synonym of 'Dupuytren's contracture', since it is more general and is used also of the milder forms of the disorder where there is no contracture. This should perhaps be made plain. Kanjuzi (talk) 18:13, 7 June 2016 (UTC)

Systematic review
The systematic review states "On balance, radiotherapy should be considered an unproven treatment for early Dupuytren's disease due to a scarce evidence base and unknown long-term adverse effects." this is based on "Only six articles met a minimum set standard, five of which were retrospective cohort studies and one a randomized controlled study. A total of 770 Dupuytren's hands, nearly all with Tubiana stage 0-1 disease, were irradiated with an average 30 Gy."

A systematic review is better than a literature review with respect to conclusions so restored the systematic review. Doc James (talk · contribs · email) 20:21, 2 June 2017 (UTC)


 * Please note also this link, accessed June 2, 2017 “Radiation is another treatment option. It is used for mild cases of contracture, when the tissue is not so thick. Radiation therapy may stop or slow thickening of the tissue. It is usually done only one time.”
 * MedlinePlus is authoritative: the United States National Institutes of Health's Web site for patients and their families and friends. Produced by the National Library of Medicine, the world’s largest medical library, it is updated daily.


 * — Preceding unsigned comment added by PhantomScholar (talk • contribs) 06:58, 3 June 2017 (UTC)
 * No that is NOT the US NIH. That is ADAM a not very good source to which they have bought a license. Doc James  (talk · contribs · email) 00:25, 4 June 2017 (UTC)
 * And in any case it doesn't contradict the content we have now. Jytdog (talk) 00:46, 4 June 2017 (UTC)

Scarce
User:PhantomScholar you have done the following:
 * initial change, 21:11, 2 June 2017
 * 1) revert 06:48, 3 June 2017
 * 2) revert 23:26, 7 June 2017
 * 3) revert 00:08, 8 June 2017

Scarcity is a form of poverty. Please justify your edit, instead of trying to force this change. Thanks. Jytdog (talk) 00:26, 8 June 2017 (UTC)

I did not intend to start an edit war, Doc James & Jytdog! I thought I was just being efficient. My objection to using the word "poor" is based on its nuances of utterly lacking quality, when the NICE review suggests that the problem is lack of quantity. (Rather understandable in a rare disease.) Characterizing  it as "poor" seems dismissive. " Scarce" or "scant" evidence seems less pejorative in tone. NICE comments also note "the large number of supportive comments received from patients who have had the procedure. " Furthermore, the European hand surgeons' journal is written for specialists who are primed to cut the hand, and not for specialists on benign fibroproliferative disorders. There are some differences in attitude. (See this link s ) I will check for recent literature aimed at radiation oncologists to provide some balance. Also, I have heard reports that some US radiation oncologists have treated more advanced stages, immediately following needle aponeurotomy or enzyme injections, in order to slow or prevent recontracture. (As is done to prevent keloid scarring.) The cited paper looked only at radiation use to treat early disease, but considering these other cases, we should state that it is used "primarily" to treat early stages. Also I noticed that the US NIH website does not distinguish between ADAM content and their own, so it presumably supports radiation as a treatment option for early disease. Radiotherapy for Dupuytren's Contracture has been in use since the mid1950s, primarily in Germany, as you know. And many doctors caution that surgery or trauma can cause the disease to flare. PhantomScholar (talk) 01:55, 8 June 2017 (UTC)

OK- after some searching, I suggest we refer also to this document when citing authorities on the efficacy of radiation therapy. https://www.rcr.ac.uk/system/files/publication/field_publication_files/BFCO(15)1_RTBenigndisease_web.pdf (published by the Royal College of Oncologists)   Here's the significant quote from page 85    Recommendations and radiotherapy technique "RT is effective in the early stages of Dupuytren’s disease, where there is no contracture (stage N) or a contracture of up to ten degrees (N/I) (Grade B). Patients with more advanced disease should be not be treated with RT, and may be offered surgical release (Grade C). "   That is why I still object to using the word "poor"  rather than "scarce" "or  "inadequate".  In paragraph three of this section, there is this: "Evidence for radiation therapy, well used, is poor.[5]   I propose that this be rephrased -  "Evidence for radiation therapy, which is sometimes used for early disease, is scarce." PhantomScholar (talk) 17:38, 8 June 2017 (UTC)

Diathesis statistical models
In the article the term, "Dupuytren's Diathesis" is used as a diagnostic category and implies that this is a diagnostic term. Diathesis models are statistical models of disease "vulnerability" used to predict the probability of disease incidence, and sometimes disease severity, when known risk factors are met in a particular clinicall population. A discussion about diathesis models related to the article topic is important, however the implication that "Dupuytren's diathesis" is a diagnostic term, is misleading. Dr.khatmando (talk) 05:14, 11 September 2017 (UTC)

Felix Plater described this condition in 1614, claims for Dupuytren's priority are invalid.
Source Wikipedia article "Felix Plater". AnnaComnemna (talk) 12:47, 21 September 2017 (UTC)
 * Hi, thanks for contributing to the discussion about this article. The evidence may support your assertion, however because this article is about a disease with little historical content, your point might be more useful for improving the "Felix Plater" or "Guillaume Dupuytren" articles. Or if you think the evidence is sound you could consider adding a sentence within the context or this article. Cheers,

Clarification
The statement in the opening paragraphs, "Evidence for radiation therapy, well used, is poor". This isn't a sentence, and in it's current state is ambiguous. Does it mean that the clinical evidence is not used well in drawing treatment conclusions? Or does it mean that even when radiation therapy is delivered at an acceptable clinical standard, the evidence of clinical efficacy is poor?

It's a fairly important point to make in the article, and it would be good if someone could review the literary source and clarify the statement. Dr.khatmando (talk) 04:45, 11 September 2017 (UTC)


 * Improved wording which reflects reference. Camerojo (talk) 10:39, 15 October 2017 (UTC)

Not rare really
This is a better source and says "Dupuytren contracture occurs in about 5 percent of people in the United States." https://ghr.nlm.nih.gov/condition/dupuytren-contracture#statistics And does not call it rare.

For a disease to be rare it must affect less than 1 in 2000 https://rarediseases.info.nih.gov/diseases/pages/31/faqs-about-rare-diseases So the other website is not completely accurate. Doc James (talk · contribs · email) 07:08, 14 September 2018 (UTC)
 * concur w/ Doc James(as stated above very clearly)--Ozzie10aaaa (talk) 10:07, 14 September 2018 (UTC)

Woodworkers and climbers
IP editor IP:2001:8003:a0d7:8c00:9905:ff65:6f13:85ef Added (with no edit comment) uncited material indicating that rock climbing and working with your hands were potential causes of DC. There's nothing in the rest of the article to suggest that DC is an occupational hazard. I reverted it. If you want to add it back, cite please. MrDemeanour (talk) 07:47, 18 November 2018 (UTC)

There might be a bit of a cure for this
I have suffered from Dupuytren's contracture for over 6 years now. It is hereditary in my family (to my knowledge since 1907 but likely much further down the genetic line), and to this day, we just suffered from it. Gradual pinky finger curling, knots in my upper palms, itchiness, and most recently pain as my hands were going into a full curl). I am an avid golfer and initially, I could grip my clubs much better, no more sweaty palms in the sunshine to throw off my swing.  But this summer I got to the point where the curl was too tight and gripping clubs now hurt.

In a weird turn of events, I experienced a massive medical breakthrough. My Dupuytren's has receded by over 50 percent in one hand and by 30% in the other hand, in 12 days. I was freaked out. My family doctor is shocked, not only because there is really no cure to this, but because we were not intending to treat this issue, something else.

Please contact me for more information. I don't know if this is the forum for this, but no other website for this disease has a comment section where I can post this.

Sincerely, Tarrah MacPherson tarrahmac@icloud.com — Preceding unsigned comment added by 2001:569:FC9D:E100:C4B0:6933:257F:CA (talk) 10:37, 12 September 2019 (UTC)

Viking disease
This is an obscure rarely used name. We already have "It is sometimes called the "Viking disease", since it is more common among those of Nordic descent." and we mention it in the infobox.

Makes sense to mention the name in connection with the epidemiology. Doc James (talk · contribs · email) 15:30, 18 January 2020 (UTC)

Stages I - IV
The text makes several references to stages I - IV of Dupuytren's, but never defines them. It does define 3 types, which appear distinct from stages. The stages need some explanation. Pol098 (talk) 15:52, 26 January 2020 (UTC)

Prognosis
"Minimally invasive therapies may precede higher recurrence rates. Recurrence lacks a consensus definition. Furthermore, different standards and measurements follow from the various definitions."

The meaning of this isn't clear. If definition is a problem that should be at the start of the paragraph. Does "may precede" mean "may result in"?

S C Cheese (talk) 09:25, 2 September 2021 (UTC)

Untitled
Dupuytren's — Preceding unsigned comment added by 109.249.185.51 (talk) 22:37, 30 December 2021 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 29 June 2020 and 21 August 2020. Further details are available on the course page. Student editor(s): Tzolfaghari, EmjChow, P.Concepcion, UCSF PharmD Candidate, EWoo95.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 08:45, 18 January 2022 (UTC)

Mouse-over link preview to Peyronie's disease from here (NSFW)
The link to Peyronie's disease pops up an image that is NSFW and might be jarring, upsetting, or embarrassing when the link is accidently moused/hovered over. (NSFW - go ahead, try it!)

Isn't there a way to "hide" such images from a preview by the use of some sort of "NSFW" or "spoiler" tag? Perhaps replace the image with a diagram?

AreThree (talk) 22:09, 28 March 2022 (UTC)

Wording of incidence
"It was once believed that Dupuytren's most often occurs in white males over the age of 50[2] and is rare among Asians and Africans.[6]"

At this position in the article this should state the current knowledge. S C Cheese (talk) 21:38, 4 May 2022 (UTC)

Risk factors
"In January 2023, a research paper "Dupuytren's disease is a work-related disorder: results of a population-based cohort study" showed the clear link between manual work and the condition. The study was by researchers at the University of Groningen Medical Centre, Netherlands and Oxford University, UK. They found those with jobs that always or usually involved manual work were 1.29 times more likely to develop Dupuytren's disease than those who rarely or never performed it. They identified a linear dose-response relationship with cumulative manual labour over a 30-year period. "

This has now been reverted. It is inappropriate to give this much detail about a single study. S C Cheese (talk) 17:29, 21 January 2023 (UTC)
 * Sorry but, before you had posted the above, I had restored the subject text to the article on the ground that the cited content was helpful and valid. I'm happy for this to be discussed here. However, at the time, you presented your reversion as a 'minor' edit, with which I disagreed, and without a justifying edit summary. On reflection, you're right to note that other cited studies are not similarly summarised—but I can't see how that justifies deletion of instructive content. Maybe instead we could insert more detail on other helpful studies. In any event I would recommend discussion in advance of deletion. Bjenks (talk) 07:26, 22 January 2023 (UTC)
 * Thanks.
 * The length of that piece on a single study is inappropriate. For example the location of the researchers can be found from the linked publication.
 * And it has created two separate entries for "manual work": one in the bullet list (with two citations) and another for that single study. S C Cheese (talk) 14:06, 22 January 2023 (UTC)

Lead section
Total mess about treatment. Doesn't mention surgery! S C Cheese (talk) 14:55, 13 March 2023 (UTC)

contradictions
The article says both:

"More recent and wider studies show the highest prevalence in Africa (17 percent), Asia (15 percent)."

And "Dupuytren's is unusual among groups such as Chinese and Africans."

So, which is it? More common in those populations? Or less common in those populations? 216.24.45.29 (talk) 14:08, 12 May 2023 (UTC)