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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). [1] They are a sign of osteoarthritis and are caused by formation of osteophytes (calcific spurs) of the articular (joint) cartilage in response to repeated trauma at the joint. [2]
In smaller joints, such as at the fingers, hard bony enlargements, called Heberden's nodes (on the distal interphalangeal joints) or Bouchard's nodes (on the proximal interphalangeal joints), may form, and though they are not necessarily painful, they do limit the movement of the fingers significantly.
Osteophytes on the fingers or toes are known as Heberden's nodes (if on the distal interphalangeal joint) or Bouchard's nodes (if on the proximal interphalangeal joints). Treatments [ edit ]
Osteoarthritis of the hand causes stiffness of the base of the thumb, alongside enlargement of DIP and PIP joints, leading to the formation of Heberden's nodes and Bouchard's nodes respectively. [6] Such firm and bony swellings at the finger joints are caused by the growth of osteophytes .
A Bouchard's node on the proximal interphalangeal joint of the index finger of a 64 year old man. Bouchard's nodes are comparable in presentation to Heberden's nodes, which are similar osteoarthritic growths on the distal interphalangeal joints, [1] but are significantly less common.
Heberden's node: William Heberden: rheumatology: osteoarthritis: same as bouchard's nodes, but over dip joints Hegar's sign: Ernst Ludwig Alfred Hegar: obstetrics: normal pregnancy: softening of cervical isthmus appearing between 4th and 6th weeks (usually) Hess test: Alfred Fabian Hess: internal medicine: capillary fragility
Psoriatic arthritis is known to present in five distinct patterns: oligoarticular (affecting four or fewer joints); polyarticular (affecting five or more joints); prominent distal interphalangeal (DIP) joint involvement; arthritis mutilans; and psoriatic spondylitis. More than 70% of cases follow the oligoarticular pattern.
The nodes are commonly indicative of subacute bacterial endocarditis. [4] 10–25% of endocarditis patients will have Osler's nodes. [5] Other signs of endocarditis include Roth's spots and Janeway lesions. The latter, which also occur on the palms and soles, can be differentiated from Osler's nodes because they are non-tender. [3]