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

OBJECTIVE

To determine whether clinically determined Heberden's nodes (HN) and Bouchard's nodes (BN) are associated with underlying individual radiographic changes of osteoarthritis (OA).

METHODS

232 index patients with symptomatic large joint and/or hand OA, and 257 of their first degree relatives were included. HN were graded 0-2; BN were scored as present/absent. Joint space narrowing (JSN) and osteophyte (OST) were each scored 0-3 using the OARSI atlas. A weighted kappa test was used to examine intraobserver reproducibility. Odds ratio (OR) was estimated for the relationship between nodes and associated JSN and OST.

RESULTS

The adjusted OR of HN for underlying JSN in the same digit was 1.72 (95% CI 1.47 to 2.02), whereas for OST it was higher at 5.15 (95% CI 4.37 to 6.08). A similar trend was seen with BN and underlying OA, with OST having a higher OR (OR = 2.98, 95% CI 2.55 to 3.47) than JSN (OR = 1.62, 95% CI 1.37 to 1.91).

CONCLUSION

There is a positive relationship between HN/BN and underlying radiographic changes of OA, especially OST. Nodes do appear to link pathologically to OA in interphalangeal joints.