Heberden’s nodes are hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes). They are a sign of osteoarthritis and are caused by the formation of osteophytes (calcific spurs) of the articular (joint) cartilage in response to repeated trauma at the joint.
Heberden’s nodes typically develop in middle age, beginning either with chronic swelling of the affected joints or the sudden painful onset of redness, numbness, and loss of manual dexterity. Therefore this initial inflammation and pain eventually subside, and the patient is left with a permanent bony outgrowth that often skews the fingertip sideways.
Osteoarthritis (OA) is a type of joint disease that results from the breakdown of joint cartilage and underlying bone. The most common symptoms are joint pain and stiffness. Initially, symptoms may occur only following exercise; but over time may become constant. Consequently, symptoms may include joint swelling; decreased the range of motion, and, when the back is affected, weakness or numbness of the arms and legs.
The most commonly involved joints are those near the ends of the fingers; therefore at the base of the thumb, neck, lower back, knee, and hips. Joints on one side of the body are often more affected than those on the other. Usually, the symptoms come on over years. It can affect work and normal daily activities. Unlike other types of arthritis, only the joints are typically affected.
Periarticular bone area expansion
The presence of Heberden nodes (HNs) may associated with increased periarticular bone area expansion in the knee joint; according to study data published in Arthritis & Rheumatology. Investigators abstracted data from the Foundation for the National Institute of Health project; a nested case-control study of participants in the Osteoarthritis Initiative cohort. Patients underwent clinical examination for the presence of HNs at baseline and at 24-month follow-up.
Knee osteoarthritis-related structural damage was also with magnetic resonance imaging (MRI); at the same time points. Investigators read MRI data per the semi-quantitative MRI; Osteoarthritis Knee Score and quantitative assessment of periarticular bone morphology methods. Linear and logistic regression to examine the association between HN positivity at baseline and subsequent worsening of MRI-defined osseous structural damages.
Patients with baseline HN
A total of 575 participants in the analysis; 395 had HN at baseline. Over 24 months, patients with baseline HN experienced greater periarticular bone area expansion in the knee joint (adjusted odds ratio [aOR], 1.39; 95% CI, 1.06-1.83) compared with patients without HN.
In conclusion in the medial femur (aOR, 1.49; 95% CI, 1.05-2.13), lateral femur(lf) (aOR, 2.51; 95% CI, 1.58-3.97), femoral notch(fn) (aOR, 1.37; 95% CI, 1.02-1.84), and lt (aOR, 1.44; 95% CI, 1.08-1.90). However, in patients with HN, there was a trend toward less osteophyte worsening in the whole knee joint (aOR, 0.63; 95% CI, 0.40-1.02), particularly in the femur area (aOR, 0.54; 95% CI, 0.31-0.95), compared with patients without HN.