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

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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 κ 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.