Soft tissue ?¿

[jim king]

Doctorb:

I have been searching the internet and have found nothing to study on this.  My wife has these blister like things below both ring fingers but they are not blisters , they are permanant.  They seem to be fatty deposits or something and are soft.

She thinks they are causing pain that goes up her arms sometimes and many times she feels as if he hands are burning.  Got the doctors stumped here.  She has had them since before the accident.

Any idea what to Google ?¿  Or is it just old age.

They appear harmless and probably are but she worries about them.

[doctorb]

Jim

From what you've told me, I can't hazard a guess.  Ther are several types of benign nodular type tumors and cysts that are common in the hand and fingers.  They may cause symptoms because the hands are so sensitive to small masses.  They would not cause radiation or neurologic symptoms up the arm.  How about a picture?

[jim king]

How about a picture?

Doc:  To many pain killers, the photos are on the post  8) 

[jim king]

Doctorb:

It looks like what you said.  Harmless cysts.  Other cites say they can be on the palms also.

Treatments and drugs
By Mayo Clinic staff

Ganglion cysts are often harmless and painless, requiring no treatment. In fact, in many cases, doctors recommend a watch-and-wait approach before exploring treatment options.

However, if the ganglion cyst is causing pain or it's interfering with joint movement, your doctor may recommend one of several treatment options.

Immobilization
Because activity can make the ganglion cyst grow larger,  your doctor may recommend wearing a wrist brace or splint to immobilize the area. This helps your hand and wrist to rest, which may help shrink the cyst. As the cyst shrinks, it may release the pressure on your nerves, relieving pain.

Aspiration
In aspiration, your doctor drains the fluid from the cyst. To do so, your doctor applies a local anesthetic to the area above the cyst. Then, he or she punctures the cyst with a needle and removes the fluid from the base of the cyst with a syringe. Your doctor may recommend a steroid injection into the empty cyst after aspiration. This procedure can be done right in your doctor's office.
After aspiration, as many as 60 percent of ganglion cysts may recur. If the cyst recurs, aspiration can be repeated. However, in some cases your doctor may recommend surgery to remove the cyst.

Surgery
If you have significant pain or difficulty with joint movement, or if other treatments aren't working, your doctor may recommend surgery to remove the ganglion cyst.
In most cases, doctors perform the surgery on an outpatient basis, which means you'll go home the same day as the operation

Another site:
•Ganglion cysts most commonly occur on the back of the hand (60%-70%), at the wrist joint, and can also develop on the palm side of the wrist. When found on the back of the wrist, they become more prominent when the wrist is flexed forward. Other sites, although less common, include these:



◦The base of the fingers on the palm, where they appear as small pea-sized bumps

[doctorb]

Sorry home Internet done  I think it looks like Duputryn's Contracture. Hard to do this on an iPhone.

[jim king]

Even Google doesnt have much on that one but what I could find it is more discomfort and inconvienience that worrysome.   

[Tom]

Jim, Dupuytren's contracture is what I thought it was too.  I have it in both hands and my ring fingers, while not being bent in the finger, are pulling at the knuckle where the finger is attached to the hand.  There is a hard knot just below the joint in the palm and fleshy areas on either side.  They aren't puffy, but seem to be flesh that is pushed up as the hard area is pulled down into the palm.  It is progressing and I can feel the stressed leader all the way down to the two fatty mounds at the base of the thumb and the heel of the hand.

You might consider her geneology.   It's interesting to find that this syndrome/ailment is traced to the small number of Vikings who entered and harassed Scotland back in pre-1000 AD and afterward.  While the "disease" is found in other ethnicities, It is usually associated with the Northern Europeans and Scots, because of the invasion.

It can be relieved by surgery when they scrape the scarred tendon, either by open surgery or with a newer procedure using a needle.   It isn't a permanent fix and it will return.

I've got an interesting doctor who explained some of this to me.  He said that "you might have to have something done if gets too bad."  It never has gotten too bad for him to consider surgery, but it, and the arthritis, sure stopped my guitar and piano playing.

It you find that this is what your wife has, tell her that she is in good company.  It's fairly common. 

There is a foot version of it called lederhose's disease too.

[jim king]

Thank you for the info Tom.  I had no idea that this existed much less that it was common.   She has a burning sensation in her hand and arm that comes and goes.  If surgery does not last I guess one best learn to live with it.

The worst bumps are in front of her ring finger on each hand and her mothers family did come over from Norway to Northern Wisconsin.

[ely]

looks like the ganglion cyst that i had on my right hand palm belom my index finger for umpteen years. not palm but the point where the finger is connected to hand.
mine got to where it hurt to turn a doorknob or screwdriver, to the point when i bumped it i would have tears in my eyes. i likened it to getting whacked in the cahonees several times... very painful in the end.

had it taken out several years ago and its been fine since.... 6000 bucks and i was out exactly 27 minutes.

[Ron Scott]

Looks similar to a hand problem that a retired forestry associate of mine has.
He has had surgery on both hands by a doctor specializing on such hand surgeries. I'm not sure that its a final fix though. He just had his right hand done a couple weeks ago.

[doctorb]

Sorry I can't give a full
explanation because of computer problems at home. Surgery is needed for 2 reasons. 1.  Pain and a "masseffect"
in the palm with grip. 2.  The scarring involves the flexor
tendons and you slowly lose the ability to straighten you fingers. It's not uncommon and is usually slowly progressive

[doctorb]

Oh, and Jim, I'm off the percocet !! :D

[beenthere]

Here is a copy of a note I received from a close friend, with similar surgery. Supportive of what you are talking about.

My hand surgery was for Dupuytrens contracture, which is a formation of growth on the tendons in the hand.  The growth causes fingers to contract. On my right hand the pinky and ring finger were contracting more and more and beginning to hurt.  One Dr. told me about the surgery and said that sometimes the fingers straighten out after surgery and can't be bent. So I went to another Dr. who works with both the ........... for hand surgery.  He told me that he does more of this surgery than anyone in WI, and assured me that I would regain complete use of my hand.  I just passed 5 weeks since surgery and I am gaining full use of my hand.  However, last Saturday I tried to prune some rose bushes and found that I need a lot of strengthening in my hand. I am sure that that will come back in due time if I keep exercising.

[doctorb]

Ahhhhhhh!  Internet restored!

Most patients put up with Dupuytrens for quite a while. As the fingers (small and ring most common) flex and can't be straightened, it's hard to place your hand inside a pants pocket.  Try it.  That's one one the times that patients seem to want something done.  Jim - as your wife has minimal fixed contractors - her fingers still extend straight - I do not think anything is needed now.  If she complains that every time she tries to twist a door knob or hold a pot of water above the stove, maybe further tx. should be considered. 

Here in the States, I would only let a hand or upper extremity fellowship trained surgeon perform this surgery on me or my family. It tends to go well, and the patients seem pleased with their results, even with the risk of recurrence.  This is one of those diagnosis that, if you need surgery, you should be asking your potential surgeons how many of these they perform, etc.  etc.

[submarinesailor]

Here in the States, I would only let a hand or upper extremity fellowship trained surgeon perform this surgery on me or my family. It tends to go well, and the patients seem pleased with their results, even with the risk of recurrence.  This is one of those diagnosis that, if you need surgery, you should be asking your potential surgeons how many of these they perform, etc.  etc.

I agree completely.  I wish at I had known this before I let that @#$%^&*@#$%^&@#$%^&*&&^% operate on my left hand.  Don't get me started!!!!!!! :( :( :( :( :( :( :(

Bruce

[ely]

on a side note, the 6k i spent on my hand was worth every penny. no second thoughts there. my doc was a younger doctor but it is his business specialty.

[doctorb]

Age, intellectual interest, and experience are not necessarily related in medicine.  The guy I would refer you to here in Baltimore is less than 40 y.o., but he's a great hand surgeon.