Quantitative and topographic assessment of Heberden's nodes for prediction of knee osteoarthritis: data from osteoarthritis initiative

Heberden's Nodes and Knee Osteoarthritis–Related Osseous Structural Damage: Exploratory Study From the Osteoarthritis Initiative

“…The potential role of HNs as prognostic factors for knee OA progression has been suggested in several reports . In our recent study, we also confirmed that the presence, number, and symmetry of HNs were associated with increased risk of radiographic knee OA .…”

“…However, these results may suggest a distinct pathophysiology of knee OA in patients with HNs as a possible indicator of generalized OA . Although osteophytes are believed to be a late secondary sequela or compensatory repair mechanism in OA and an indicator of advanced knee OA , our finding of less worsening in the osteophyte score, despite the reported increased risk of radiologic knee OA progression associated with HNs , may suggest that less ossification is involved in the pathophysiology of knee OA in the presence of HNs. In general, it is possible that the more rapid course of OA and the reduced ossification in the presence of HNs may be associated with decreased osteophyte formation.…”

“…Meta‐analysis of all prognostic factors for radiographic knee OA progression demonstrated the significant role of HNs in predicting knee OA progression, with an overall OR of 2.66 (95% CI 1.46, 8.84) . In our recent study using the OAI data set with 8‐year followup and a large sample size of 8,023 knees, we found that the presence and numbers of HNs determined at baseline physical examination were associated with radiologic incidence and progression of knee OA over 8 years .…”

“…Regarding the assessment of HNs, clinical examination has only moderate reliability, and lack of reliability confirmation in the OAI data set results in potential misclassification. Finally, topographic distribution/quantitative assessment of HNs, which has been shown to be a determinant of knee OA incidence and progression , was not investigated in the present study.…”

Editorial: What Can Our Hands Tell Us About the Future of Our Knees?

“…In this issue of Arthritis & Rheumatology , Kumar et al () present an analysis of the association between Heberden's nodes and subsequent incidence or progression of knee OA. The authors used data from the Osteoarthritis Initiative (OAI), a multicenter observational cohort study of subjects in the US with, or at high risk of, knee OA.…”