What are heberden and Bouchard nodes associated with?
What is the difference between Herbenden’s and Buchard’s Nodes? What do they look like? Heberden’s nodes (at the DIP joints– most distal knuckle) and Bouchard’s nodes (at the PIP — middle knuckle) of the hands look like bony enlargement (knobs or nodes) at the joint. They are hard (becasue they are bone) and occasionally become inflammed and painful. Both are
features of osteoarthritis. Founded in 1998, the Arthritis Center at Johns Hopkins is dedicated to providing quality education to patients and healthcare providers alike. Are you experiencing pain or stiffness in your fingers? It could be a sign of osteoarthritis (OA), a degenerative joint disease that can affect the joints in your hands and elsewhere. People with OA in their hands often develop bumps on their fingers known as Heberden’s nodes. These bumps are usually one of the most obvious signs of OA in the hands. Heberden’s nodes are bumps that affect the part of the finger that’s nearest the tip. Another type of bump, Bouchard’s nodes, affect the joint that’s nearest the hand. Heberden’s nodes are described as “bony swellings” that form on your hands as a result of osteoarthritis. They’re named after physician William Heberden Sr., a doctor in the 1700s. He came up with the description of these swellings. These firm growths occur on the finger joints nearest the fingertip, also called the distal interphalangeal joints. Similar swellings located on the lower joints, or the proximal interphalangeal joints, are called Bouchard’s nodes. Osteoarthritis typically affects the:
The joints in these areas have cartilage that cushions and protects the surface of your bones. Osteoarthritis may often result from the wear and tear that comes with aging, but it can develop after an injury. In the case of Heberden’s nodes, there’s a degree of uncertainty about how the disease process evolves. Research shows that the process may involve:
It also indicates that there may be some changes in soft tissue, as well as bone. The cartilage can degrade and become unable to protect your bones. Without this protection, the bones begin to rub against each other. This process can destroy existing bone and cause significant pain, which can be an early sign of OA and the development of nodes. Over time, the pain may lessen, but the deformity progresses. As the cartilage continues to break down, new bone grows alongside the existing bone in the form of nodes or bony spurs. By the time the nodes appear, your fingers may have become stiff, and the pain may have lessened. Heberden’s nodes tend to appear after severe joint damage has already occurred, so they’re often seen as a marker of advanced OA, which is referred to as nodal OA. If you have Heberden’s nodes, you can often see them by examining the end joints on your fingers. Tiny firm-hard swellings may extend from the joint closest to your fingernail. In many cases, your fingers may twist or become crooked as the nodes form. Symptoms include:
Here are some other features of Heberden’s nodes:
Some cases of Heberden’s nodes may be asymptomatic or only cause mild or few symptoms. If you have Heberden’s nodes, you may have difficulty performing some tasks that require gripping or pinching, like turning the key in your car’s ignition or uncapping a soda bottle. You may feel limited in your daily activities, and it may be hard to complete tasks for work or household chores. This can affect your quality of life. For some people, it could even lead to the development of a mental health disorder, such as depression and anxiety. Osteoarthritis is the most common type of arthritis. It often affects older people, but over half of those who have both OA and Heberden’s nodes receive a diagnosis before age 65. Other risk factors include:
There’s no specific treatment for Heberden’s nodes. Possible options for relieving pain may include:
In one small study, researchers found that low-level laser therapy reduced pain and swelling and increased mobility in people with Heberden’s and Bouchard’s nodes. However, more research is necessary to identify the best ways to deliver this procedure and examine the long-term effects. Treatments for OA of the handA wide range of treatments can help you manage OA of the hand, although they’re not specifically for Heberden’s nodes. Treatment will aim to:
However, it’s not yet possible to repair damage that has already occurred. Lifestyle choicesExperts from the American College of Rheumatology and the Arthritis Foundation (ACR/AF) recommend taking an active role in your own treatment plan, which includes learning new skills and working with your healthcare provider to make decisions about treatment. Options may include:
Some people with OA find that the use of elastic “arthritis gloves” with open fingertips helpful for increasing their hand mobility. Experts recommend exercise for everyone with OA, including OA of the hand. Staying active can help improve overall strength and flexibility, and it may help manage stress and anxiety. Specific exercises may help keep your fingers mobile. Other home and alternative therapies include:
There’s some evidence that these therapies may help with pain and stiffness, although more research is needed to confirm their benefits. Options to avoidPeople sometimes use the following, but the ACR/AR strongly advise against using them for hand OA:
Studies haven’t shown that these are beneficial, and some may cause adverse effects or interact with other drugs. MedicationsOver-the-counter medications include:
If these do not work, your healthcare provider may prescribe:
Occasionally antidepressants may be prescribed to help relieve stress, anxiety, and depression, which can occur with many chronic conditions. SurgerySurgical treatment is usually a last resort after conventional treatment options have proven unsuccessful, and it’s rarely done. Joint replacement surgery is common in knee and hip OA but not for arthritis of the fingers or thumbs, as it has a low success rate. If you’re experiencing pain, swelling, and a loss of motion in your fingers, it’s a good idea to see a doctor. They will:
If your doctor diagnoses OA, they’ll work with you to make a treatment plan that suits you. What are heberden's nodes associated with?Heberden's nodes are small, pea-sized bony growths that occur on the joint closest to the tip of the finger, also called the distal interphalangeal joint. Heberden's nodes are a symptom of osteoarthritis (OA) of the hand.
What are Bouchard's nodes associated with?Bouchard's nodes are a typical symptom of osteoarthritis of the hands. They are small bony growths that appear on the middle joint of the finger. They occur due to damage to the cartilage or joint.
What are heberden's and Bouchard's nodes which joints are they associated with?Bony bumps on the finger joint closest to the fingernail are called Heberden's nodes. Bony bumps on the middle joint of the finger are known as Bouchard's nodes. Bony bumps are also common at the base of the thumb. These bumps do not have a nickname, but the joint is called the CMC or carpometacarpal joint.
Are Bouchard's nodes associated with rheumatoid arthritis?A Bouchard's node is considered a characteristic sign of osteoarthritis, helping differentiate it from other types of arthritis such as gout or rheumatoid arthritis. With that said, there are also bumps associated with rheumatoid arthritis and gout.
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