Dupuytren's contracture

Case history

A 60-year-old man of northern European descent presents with a several-year history of a mass on the ulnar side of his palm. He has no significant past medical history. The patient states that this mass has increased in size over the past year and is now causing his small finger to bend down. He has no pain but is increasingly bothered by the flexion deformity of his small finger, as it is hard for him to put on a glove, and his finger often gets caught on things. On physical examination there is a cord palpable over the small finger and ring finger rays, with extension across the metacarpophalangeal joint of the small finger producing a contracture of 50 degrees in this joint. There is no proximal interphalangeal joint involvement. Plain x-rays and laboratory studies are normal.