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

Thaper, Amit; Zhang, Weiya; Wright, Gary; Doherty, Michael

doi:10.1136/ard.2004.031450

Cited by 35 publications

(35 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Heberden nodes (HN) and Bouchard nodes (BN) associate with underlying structural changes of HOA, especially osteophyte (OR = 5.15, 95% CI 4.37 to 6.08) 58 – 60. However, their sensitivity and specificity for HOA vary widely from 0.3 to 0.9 depending on the cut-off grade, gold standard and control subjects.…”

Section: Propositionmentioning

confidence: 99%

EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT

et al. 2008

View full text Add to dashboard Cite

Objectives: To develop evidence-based recommendations for the diagnosis of hand osteoarthritis (OA). Methods: The multidisciplinary guideline development group, representing 15 European countries, generated 10 key propositions regarding diagnosis using a Delphi consensus approach. For each recommendation, research evidence was searched for systematically. Whenever possible, the sensitivity, specificity and likelihood ratio (LR) were calculated; relative risk and odds ratios were estimated for risk factors for hand OA. Quality of evidence was categorised using the European League Against Rheumatism (EULAR) hierarchy, and strength of recommendation was assessed by the EULAR visual analogue scale. Results: Diagnostic topics included clinical manifestations, radiographic features, subgroups, differential diagnosis, laboratory tests, risk factors and comorbidities. The sensitivity, specificity and LR varied between tests depending upon the cut-off level, gold standard and controls. Overall, no single test could be used to define hand OA on its own (LR ,10) but a composite of the tests greatly increased the chance of the diagnosis. The probability of a subject having hand OA was 20% when Heberden nodes alone were present, but this increased to 88% when in addition the subject was over 40 years old, had a family history of nodes and had joint space narrowing in any finger joint. Conclusion: Ten key recommendations for diagnosis of hand OA were developed using research evidence and expert consensus. Diagnosis of hand OA should be based on assessment of a composite of features.

show abstract

Section: Propositionmentioning

confidence: 99%

EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT

et al. 2008

View full text Add to dashboard Cite

show abstract

“…[4] Nodüller, osteofit gibi altta yatan yap›sal anormallikler ile ilgilidir. [5][6][7] Bu tipik el OA's› iflaretleri a¤r›, tutukluk, hareket kayb›, azalm›fl kavrama gücü ve hareket k›s›tl›l›¤›na neden olabilmektedir.…”

Section: El Osteoartritinin Tan›s›unclassified

Approach to hand osteoarthritis

Ermurat¹,

Dalkılıç²

2016

RAED Derg

View full text Add to dashboard Cite

“…The nodes affecting the thumb IP and metacarpophalangeal (MCP) joints were also documented. This method has been previously validated (7,13). Intraobserver reproducibility was determined by the metrologists' reassessment every 2-3 months.…”

Section: Methodsmentioning

confidence: 99%

“…Multiple nodes are regarded widely as a marker for generalized OA (4). Few studies have investigated the association between hand nodes and underlying structure changes (5)(6)(7)(8). In the studies that have investigated this, the measures used to assess the association were inconsistent, which led to a different clinical interpretation of the association.…”

Section: Introductionmentioning

confidence: 99%

“…However, Cicuttini et al (6) reported poor agreement between Heberden's nodes and radiographic distal IP (DIP) joint osteophytes, although after examining the statistics there was a small but statistically significant relationship. Thaper et al (7) reported a positive association with both JSN and osteophytes and suggest they can be used as a clinical marker. Hart et al (8) examined Kellgren/Lawrence (K/L) scores and reported a high specificity but low sensitivity association and concluded that they were not able to replace radiographic definition with clinical nodes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Distribution of finger nodes and their association with underlying radiographic features of osteoarthritis

Rees¹,

Doherty²,

Hui³

et al. 2012

Arthritis Care & Research

View full text Add to dashboard Cite

Objective. To determine the distribution of clinically palpable hand interphalangeal (IP) nodes at each finger and thumb joint in a population with nodes, the influence of left or right hand dominance and sex on the development of nodes, and the association between nodes and underlying radiographic features of osteoarthritis (OA). Methods. We performed a cross-sectional analysis of participants in the Genetics of Osteoarthritis and Lifestyle (GOAL) study who had >1 Heberden's nodes or Bouchard's nodes on clinical examination. Frequencies (%) of nodes were described for each IP joint in the hand. Associations between nodes and underlying radiographic OA were shown with odds ratios (ORs) and 95% confidence intervals. A logistic regression model was used to adjust for the following confounding factors: age, sex, body mass index, left or right hand dominance, hand trauma, occupation with heavy manual activity, and participation in sports. Results. Of the 3,170 GOAL participants, 1,939 had >1 nodes (mean age 68 years, 54% women). The distal IP joints of the index finger were the most frequently affected, followed by the thumb IP joint. Nodes were more common in dominant hands and women. There was a significant association between nodes and underlying radiographic OA (OR range 2.26 -21.23). This association was stronger for joint space narrowing than for osteophytes. A dose-response relationship was found between clinical severity of Heberden's nodes and underlying radiographic change. Conclusion. Our study supports the positive association between nodes and radiographic OA, especially narrowing, and the influence of sex and left or right hand dominance on development of nodes. In this age group, presence of nodes may be taken as an indication of underlying small joint OA.

show abstract

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

Cited by 35 publications

References 8 publications

EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT

EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT

Approach to hand osteoarthritis

Distribution of finger nodes and their association with underlying radiographic features of osteoarthritis

Contact Info

Product

Resources

About