What Are Heberden's Nodes?

Visible signs of osteoarthritis (OA) are an important element when the disease is being diagnosed. Diagnosis of other types of arthritis, such as rheumatoid arthritis and gout, often relies more heavily on laboratory tests.

Heberden's Nodes Explained

Heberden's nodes, named after William Heberden who discovered the nodes, are a classic sign of hand osteoarthritis (the third most commonly affected joint following osteoarthritis of the knee and hip). Heberden's nodes are bony enlargements of the joint closest to the fingertip -- also known as the DIP joint or distal interphalangeal joint.

• Heberden's Nodes (Illustrated)
• Heberden's Nodes (Photo from Merck)

The Significance of Heberden's Nodes

In scientific studies, there has been a dispute over whether there is a correlation between Heberden's nodes and a specific subset of osteoarthritis, known as generalized osteoarthritis. A study in Osteoarthritis and Cartilage (2006) suggests, "In patients with Heberden's nodes, the OA starts with the subchondral ossification (mineralization and thickening of bone just under cartilage). Heberden's nodes are the specific manifestation of GOA (generalized osteoarthritis) in the distal finger joints."

There is another controversy too that surrounds Heberden's nodes -- whether Heberden's nodes are synonymous with DIP osteophytes. One study in the Annals of the Rheumatic Diseases (1998), suggests they are not synonymous.

Bottom Line

Amid the controversies, most resources agree that Heberden's nodes are most common in women who are post-menopausal. Studies suggest a genetic predisposition to developing Heberden's nodes, whereby the associated gene is dominant in women and recessive in men.

_Sources:

_{Investigations in generalized osteoarthritis. Part 1: genetic study of Heberden's nodes. Irlenbuscg U. et al. Osteoarthritis and Cartilage. May 2006.
http://www.ncbi.nlm.nih.gov/pubmed/16443379}

_{Investigations in generalized osteoarthritis. Part 2: special histological features in generalized osteoarthritis. Irlenbuscg U. et al. Osteoarthritis and Cartilage. May 2006.
http://www.ncbi.nlm.nih.gov/pubmed/16442315}

_{Relation between Heberden's nodes and distal interphalangeal joint osteophytes and their role as markers of generalized disease. Cicuttini FM et al. Annals of the Rheumatic Diseases. April 1998.
http://www.ncbi.nlm.nih.gov/pubmed/9709182}

_{Osteoarthritis of the hip and Heberden's nodes. McGoldrick and O'Brien. Annals of the Rheumatic Diseases. January 1989.
http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1003675&pageindex=1#page}