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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(01): 58
DOI: 10.1590/0004-282X20170164
IMAGES IN NEUROLOGY

“Acute Dupuytren’s contracture”: the answer is not always in your hands

“Contractura de Dupuytren Aguda”: a resposta nem sempre está nas mãos
Tiago Geraldes
1   Hospital Garcia de Orta, Departamento de Neurologia, Almada, Portugal;
,
Rui Carvalho
2   Hospital Garcia de Orta, Departamento de Neurorradiologia, Almada, Portugal.
,
Miguel Grunho
1   Hospital Garcia de Orta, Departamento de Neurologia, Almada, Portugal;
,
Carolina Pires
1   Hospital Garcia de Orta, Departamento de Neurologia, Almada, Portugal;
,
Ana Cláudia Ribeiro
1   Hospital Garcia de Orta, Departamento de Neurologia, Almada, Portugal;
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A 56-year-old man with prior left hand Dupuytren’s contracture suddenly developed a right hand Dupuytren’s contracture-like posturing ([Figure A]). Bilateral palmar fascial thickening with flexion deformity of the fingers was noted. Neurological examination also disclosed weakness of the right wrist and finger extension, as well as of thumb and index finger abduction. Brain MRI revealed an acute infarction in the left precentral “hand knob” area[1],[2],[3],[4] ([Figure B], [C] and [D]). We emphasize that Dupuytren’s contracture, a supposedly straightforward orthopedic disorder, can be a stroke chameleon. By unbalancing a previous subclinical condition, due to predominant weakness in the extensors, cortical “hand knob” infarction presented as an “acute Dupuytren’s contracture” in this patient.

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Figure A) Right hand “acute Dupuytren’s contracture-like posturing” with concomitant prior left Dupuytren’s contracture; B) Axial DWI; C) Axial ADC; D) Axial T2 FLAIR.


Publication History

Received: 18 November 2016

Accepted: 11 August 2018

Article published online:
30 August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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