Heberden s nodes

The prevalence of OA is higher in women, and they have more generalized disease. Women are also more likely to have inflammation of the proximal and distal interphalangeal joints of the hands, which manifest as Bouchard s and Heberden s nodes, respectively. OA of the hip occurs more frequently in men. 

Distal interphalangeal finger joints (Heberden s nodes)... 

Many physicians in the early eighteenth century had doubts as to whether Mithridatium was the universal panacea of all illness as claimed. The ultimate mortal attack on the remedy came from Dr William Heberden (1710-1801) (see Figure 16.3), better known clinically for his description of the Heberden s nodes in osteoarthritis. Consequently, the 1746 edition of The London Pharmacopoeia was the last in... 

OA severity also increases with age. " For those between 65 and 74 years of age, 33% have moderate to severe knee OA, and 50% have moderate to severe hip OA. The National Arthritis Data Workgroup, using National Health and Nutrition Examination Survey and other data, has projected that by the year 2020, 18.2% of Americans (59.4 million people) will be affected by OA. In the United States, women are more often affected by OA older women are twice as hkely as men to have OA of the knee and hands. " Women are also more likely to have inflammatory OA of the proximal and distal interpha-langeal joints of the hands, giving rise to the formation of Bouchard s and Heberden s nodes, respectively. Knee OA appears to be twice as prevalent in black as opposed to white women. Chinese, East Indian, and Native American people have lower incidences of hip OA than do Caucasians. 

First metatarsophalangeal involvement Periarticular osteopenia Bone erosions Heberden s nodes Tests for rheumatoid factor Renal failure(a blood urea of more than 50 mg/lOOml) and/or proteinuria... 

Bone erosions Periarticular osteopenia Vascular disease Hypertension Heberden s nodes Renal failure and or proteinuria Rheumatoid factor Tophi... 

The frequency of periarticular osteopenia was striking and might be related to disuse and/or to an active synovitis. The frequency of Heberden s nodes was more common than anticipated and was independent of age of the patient and duration of gout. 

Physical examination ofthe affected joints reveals tenderness, crepitus, and possible joint enlargement. Heberden s and Bouchard s nodes are bony enlargements (osteophytes) ofthe DIP and PIP joints, respectively. 

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