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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. Heberden's nodes are more common in women than in men, and there seems to be a genetic component involved in predisposition to the condition.
Osteoarthritis; Other names: Arthrosis, osteoarthrosis, degenerative arthritis, degenerative joint disease: The formation of hard knobs at the middle finger joints (known as Bouchard's nodes) and at the farthest joints of the fingers (known as Heberden's nodes) is a common feature of osteoarthritis in the hands. Pronunciation /
They are seen in osteoarthritis, where they are caused by the formation of calcific spurs of the articular (joint) cartilage. Much less commonly, they may be seen in rheumatoid arthritis, where nodes are caused by antibody deposition to the synovium. A Bouchard's node on the proximal interphalangeal joint of the index finger of a 64 year old man.
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. [7]
Osteophytes form because of the increase in a damaged joint's surface area. This is most common from the onset of arthritis. Osteophytes usually limit joint movement and typically cause pain. [6] Osteophytes form naturally on the back of the spine as a person ages and are a clinical sign of degeneration in the spine.
Other rheumatological disorders that can cause the features typical for RS3PE include late onset (seronegative) rheumatoid arthritis, acute sarcoidosis, ankylosing spondylitis and other spondyloarthropathies such as psoriatic arthropathy, mixed connective tissue disease, chondrocalcinosis and arthropathy due to amyloidosis. [6] [9]
Treatment can vary depending on the cause and severity of the condition. Physical therapy, acupuncture, and anti-inflammatory drugs are commonly used to treat the disease. In more severe cases, intra-articular corticosteroid injections or surgical joint replacement may be necessary. Joint drainage and antibiotics are used to treat septic arthritis.
Common drug therapies, such as anti TNF treatment or other immunosuppressive drugs, for rheumatoid arthritis has shown little effect on the nodules. [23] In fact, it has been shown that Methotrexate, a drug often used in rheumatoid arthritis, is actually correlated with the increased risk of nodule formation. [ 13 ]
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