Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Interestingly, Dupuytren
contracture is sometimes associated with inflammation and thickening of the
fascia tissue in a similar manner of the sole of the foot. This condition is
called plantar fasciitis. Very rarely,
Dupuytren contracture occurs in association with an uncommon scarring condition
of the penis, called Peyronie's disease.
How is Dupuytren contracture diagnosed?
Dupuytren's contracture is
diagnosed by the doctor
during the physical
examination of the affected hand.
Previous burns or hand injury can lead to scar formation
in the palm of the
hand which can mimic true Dupuytren contracture.
How is Dupuytren contracture treated?
The treatment of Dupuytren contracture depends on the
severity and the underlying condition of the affected
individual.
Most patients with Dupuytren contracture require
reassurance and stretching exercises with heat
application. When the palm is persistently sore with
grasping, ultrasound
treatments can be helpful. Sometimes local inflammation is best relieved with
cortisone
injection.
For patients with significant fixed flexed posture
(contracture) of the fingers from Dupuytren contracture, surgical procedures can
remove the scarred tissue to free the fingers. These procedures can return
function to a disabled hand. Minor nodule formation and/or skin thickening of
the palm is not a reason to operate. Sometimes the surgeon can release the scarred tissue by carefully cutting it with a
needle. This procedure is referred to as a needle aponeurotomy.
Dupuytren contracture is a localized scar tissue
formation in the palm.
The precise cause of Dupuytren contracture is not
known.
Dupuytren contracture is sometimes inherited.
Dupuytren contracture can limit extension of the
affected finger.
The treatment of Dupuytren contracture depends on the
severity and the underlying condition of the affected
individual. Treatments include stretching, heat, ultrasound, local cortisone injection, and surgical procedures.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
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