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EN
Dupuytren’s disease is typically observed in adults, in children and adolescents being rarely diagnosed. Only several cases were reported in children under the age of 10 years, including two infants under one year. There were no such reports in Polish literature. We presented a case of Dupuytren’s disease in a 17 year-old adolescent, in whom the first signs of the disease were observed in early childhood.
EN
The etiology of Dupuytren’s disease is controversial and thus the disease can only be treated when it presents with symptoms to warrant intervention. Surgical treatment is the method of choice to preserve hand dexterity and function. It is advisable to perform surgery at an early stage of disease progression, but various surgical techniques have been advocated. A partial fasciectomy is recommend by many authors, whereas a total aponeurectomy, where all palmar tissue is removed, might reduce the risk of recurrent disease due to the widespread removal of aponeurosis. The total aponeurectomy is performed less frequently due to the potential complications of this technique. In order to achieve an objective comparison of both surgical options we performed a literature meta-analysis, involving a comparison of surgical indications, results and complications following partial and total aponeurectomy, which are described in detail within this review article.
EN
Knuckle pads are rare harmless subcutaneous nodules that must be differentiated from joint disease of the proximal interphalangeal or rarely of the metacarpophalangeal joints as well as from other masses of the paraarticular tissues. We present a case of an otherwise healthy 36-year-old woman presenting with bilateral knuckle pads located at the dorsal aspect of the proximal interphalangeal joints. No predisposition to a specific musculoskeletal disorder was noted. Ultrasound revealed well-delimited subcutaneous hypoechoic masses without internal flow signals at color Doppler. Histology showed proliferation of myofibroblasts with a decrease of elastic filaments in the deep dermis. The clinical picture, the family history in addition to the histology allowed us to make the diagnosis of knuckle pads. We present the ultrasound findings of knuckle pads and discuss the differential diagnosis of a “swelling” in the dorsal region of proximal interphalangeal joints and metacarpophalangeal joints.
PL
Palce poduszeczkowate (knuckle pads), potocznie zwane guzkami kłykciowymi, są rzadkimi i łagodnymi zmianami podskórnymi, które należy różnicować z chorobą stawu międzypaliczkowego bliższego i, rzadziej, stawu śródręczno‑paliczkowego,a także z innymi masami/zmianami okołostawowymi. Prezentujemy przypadek 36‑letniej zdrowej kobiety, u której stwierdzono obustronne guzki zlokalizowane po stronie grzbietowej stawów międzypaliczkowych bliższych. Badanie ultrasonograficzne wykazało wyraźnie odgraniczone, hipoechogeniczne guzki zlokalizowane podskórnie, bez cech obecności nieprawidłowego unaczynienia w badaniu kolorowym dopplerem. W badaniu histopatologicznym ujawniono proliferację miofibroblastów oraz zmniejszenie liczby włókien elastycznych w głębokich warstwach skóry właściwej. Obraz kliniczny, wywiad rodzinny oraz badania histologiczne pomogły w ustaleniu rozpoznania. W artykule przedstawiamy ultrasonograficzny obraz palców poduszeczkowatych oraz diagnostykę różnicową pogrubienia tkanek miękkich okolicy grzbietowej stawów międzypaliczkowego bliższego i śródręczno‑paliczkowego.
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