Dupuytren Contracture Differential Diagnoses

Updated: Oct 05, 2016
  • Author: Stephanie Danielle Mathew, DO; Chief Editor: Herbert S Diamond, MD  more...
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DDx

Diagnostic Considerations

Dupuytren disease must be distinguished from several other conditions that affect the hand, including trigger finger, stenosing tenosynovitis, a ganglion cyst, or a soft-tissue mass. Unlike Dupuytren contracture, trigger finger typically involves pain with flexion followed by the inability to extend the affected digit.

Stenosing tenosynovitis may be distinguished from Dupuytren disease by pain and a history of overuse or trauma. A small, movable nodule that is tender to palpation at the MCP joint is likely a ganglion cyst. A soft-tissue mass must also be excluded from the diagnosis, especially if the patient is significantly younger than the typical patient with Dupuytren disease and if he or she has no other risk factors.

A patient younger than age 40 years without involvement of the dorsal hand, foot, or penis is unlikely to have Dupuytren disease; however, the possibility of a sarcoma must be ruled out—although the pathologic findings of a biopsy will most likely reveal a benign etiology (eg, lipoma, inclusion cyst).

Conditions to consider in the differential diagnosis of Dupuytren contracture include the following:

  • Diabetic cheiropathy
  • Epithelioid sarcoma
  • Fibroma
  • Giant cell tumor
  • Intrinsic joint disease
  • Lipoma
  • Neurofibroma
  • Palmar fibromatosis
  • Palmar tendinitis
  • Retinacular ganglion of the A-1 pulley
  • Tendon nodule of stenosing tenosynovitis
  • Tophi
  • Traumatic scars
  • Callus
  • Ganglion cyst
  • Prolapsed flexor tendon
  • Ulnar nerve palsy
  • Camptodactyly
  • Changes secondary to rheumatoid arthritis
  • Hyperkeratosis
  • Non-Dupuytren disease
  • Palmar ganglion

Differential Diagnoses