Heberden's nodes (HNs) are bony enlargements of the finger joints that are readily detectable in a routine physical examination and are considered hallmarks of osteoarthritis. A new  Arthritis & Rheumatology  study found that the presence of HNs may also indicate structural damage associated with knee osteoarthritis.

Heberden's nodes

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.

This initial inflammation and pain eventually subside, and the patient is left with a permanent bony outgrowth that often skews the fingertip sideways. Bouchard's nodes may also be present; these are similar bony growths in the proximal interphalangeal (PIP) joints (middle joints of the fingers) and are also associated with osteoarthritis. 

Osteoarthritis 

Osteoarthritis (OA) is a type of joint disease that results from 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. Other symptoms may include joint swelling, decreased 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, 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

In the study of 395 patients with HN and 188 without, there were significant associations between the presence of HN and imaging measures of knee osteoarthritis. The authors noted that additional studies are needed to understand the mechanisms behind the link between HN and knee osteoarthritis. "The presence of Heberden's nodes in a physical examination is associated with a distinct pattern of osteoarthritis-related structural damage in the knee joint," said lead author Dr Arya Haj-Mirzaian, of the Johns Hopkins University School of Medicine.

"These exploratory results have motivated us to initiate more focused investigations to further characterize the nodal osteoarthritis phenotype and tailor specific treatments for patients in future trials," added senior author Dr. Shadpour Demehri.