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


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.

  • aOR, adjusted odds ratio
  • BMI, body mass index
  • BN, Bouchard’s nodes
  • CI, confidence interval
  • DIP, distal interphalangeal
  • HN, Heberden’s nodes
  • JSN, joint space narrowing
  • OA, osteoarthritis
  • OR, odds ratio
  • OST, osteophyte
  • Heberden’s nodes
  • Bouchard’s nodes
  • hand osteoarthritis

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