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Ann Rheum Dis 2005;64:1214-1216 doi:10.1136/ard.2004.031450
  • Concise report

Relationship between Heberden’s nodes and underlying radiographic changes of osteoarthritis

  1. A Thaper1,
  2. W Zhang1,
  3. G Wright2,
  4. M Doherty1
  1. 1Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK
  2. 2Department of Rheumatology, Royal Victoria Hospital, Belfast BT12 6BA, UK
  1. Correspondence to:
    Professor M Doherty
    Michael.Dohertynottingham.ac.uk
  • Accepted 16 January 2005
  • Published Online First 27 January 2005

Abstract

Objective: To determine whether clinically determined Heberden’s nodes (HN) and Bouchard’s nodes (BN) are associated with underlying individual radiographic changes of osteoarthritis (OA).

Methods: 232 index patients with symptomatic large joint and/or hand OA, and 257 of their first degree relatives were included. HN were graded 0–2; BN were scored as present/absent. Joint space narrowing (JSN) and osteophyte (OST) were each scored 0–3 using the OARSI atlas. A weighted κ test was used to examine intraobserver reproducibility. Odds ratio (OR) was estimated for the relationship between nodes and associated JSN and OST.

Results: The adjusted OR of HN for underlying JSN in the same digit was 1.72 (95% CI 1.47 to 2.02), whereas for OST it was higher at 5.15 (95% CI 4.37 to 6.08). A similar trend was seen with BN and underlying OA, with OST having a higher OR (OR = 2.98, 95% CI 2.55 to 3.47) than JSN (OR = 1.62, 95% CI 1.37 to 1.91).

Conclusion: There is a positive relationship between HN/BN and underlying radiographic changes of OA, especially OST. Nodes do appear to link pathologically to OA in interphalangeal joints.

Footnotes

  • Published Online First 27 January 2005

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