Q. I suffer from hypothyroidism and over the last few months my left arm has become increasingly weak. The process accelerated recently (last 6 weeks) during a period when I moved house and was without thyroxine (T4) for three weeks. My left hand now looks like a claw and i think I’m developing a Dupuytren’s contracture. How worried should I be?! I’m back on my meds now and have been for the last 10 days. I’m very aware that time is of the essence in dealing with this issue. My hands looked the same 6 months ago!

A. Just get back to your thyroid medications. Most of such contractures are reversible.

What is Dupuytren’s contracture?

It is a condition where tissues under the skin of the palm gradually thicken and lose their elasticity. This happens over a period of few years. The condition is slowly progressive

As the tissues thicken, become more fibrous in nature. They start tightening up and force the affected area to bend towards the palm. Usually the 4th finger,ring finger, and little finger get affected.

The condition may worsen to a stage where the affected individual cannot perform his daily duties and fine hand work.

Causes Leading to Dupuytren’s Contracture

There are no known causes for this condition. We don’t understand clearly why it occurs. There are suggestions that this may be a T cell mediated response of the body. The condition may have an autoimmune etiology, with exact cause or triggers still unknown.

However, there are certain condition which have been seen associated with it. Prevalence of Dupuytren’s contracture is found more in:

  • Alcoholics
  • Smokers
  • Diabetics
  • Thyroid disorders
  • It’s commoner in people of North European descent
  • Male gender is seen to be more affected

Thyroid Associated With Various Musculoskeletal Problems

Thyroid disorders are commonly associated with varied forms of musculoskeletal problems. Patients with Hypothyroidism often complain of pain in their joints or different muscle groups.

It’s common for their knees, hips or shoulders to ache. Calf muscles may gradually weaken and may even stiffen with time.

The exact mechanism is not known though. But deficient levels of thyroid hormone lead to majority of defects in various connective tissues of the body. Joint capsules may thicken and become stiff. This may lead to arthritis and loss of movements over the affected joint.

Muscles may also become stiff. They may gradually fibrose and become function less.

Thyroid and Dupuytren’s Contracture

Thyroid patients have shown thickening of soft connective tissue below their palm skin. This may gradually deteriorate to loss of elasticity there. As the tissue gets more and more fibrosed, the affected side of the palm tends to bend inwards and functionality is lost.

However, in most cases where early detection of the condition is done, proper management of thyroid may reverse such contractures.

References : https://pubmed.ncbi.nlm.nih.gov/12864792/

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