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Arthritis and Rheumatism

Heberden`s/Bouchard`s Nodes

09/13/2007

Question:

Does everyone with osteoarthritis of the finger joints develop Heberden`s and/or Bouchard`s Nodes?

I`m a little confused as to the difference, if there is any, between what finger osteoarthritis and a Heberden`s node (or Bouchard`s node) is. Are the nodes the same thing--or are they something other than osteoarthritis--and are the nodes something which not everyone gets? If not the same thing, what causes some people to get the nodes and others not to?

What EXACTLY is the relationship, please between Osteoarthritis of the finger joints and Heberden`s/Bouchard`s nodes?

Thank you for your help.

Answer:

Heberden's and Bouchard's nodes are physical exam findings that suggest osteoarthritis. They are essentially the "knobby" appearance of the middle and end joints of the fingers that may be found in individuals with osteoarthritis of the hands. Bouchard's is the term applied to the middle knuckle of the finger (proximal interphalangeal joint) and Heberden's is the term applied to the end knuckle of the finger (distal interphalangeal joint). As part of the osteoarthritis process, the bone underlying the joint cartilage may be producing more bone. This boney enlargement may manifest as the aforementioned grossly visualized nodes. It is possible to have osteoarthritis of the fingers and not have these nodes.

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University