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  • Title: Relationship between Heberden's nodes and underlying radiographic changes of osteoarthritis.
    Author: Thaper A, Zhang W, Wright G, Doherty M.
    Journal: Ann Rheum Dis; 2005 Aug; 64(8):1214-6. PubMed ID: 15677702.
    Abstract:
    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.
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