Wednesday, July 1, 2009

Clinical Image – What are they?

 heberden &bouchard nodes

1.Heberden’s nodes :

  • Heberden’s nodes are a clinical sign typically associated with osteoarthritis
  • Heberden’s nodes are often described as enlargements of the terminal (or distal) interphalangeal joints of the fingers
  • The histologic nature of the nodes is unknown.
  • They normally do not arise during the acute stage of osteoarthritic development, but rather during the chronic stage.In the acute stage, joints become erythematous, warm, and very tender to the touch. At this point, the joints are usually slightly swollen and may exhibit effusion. In addition, during the acute stage, pain in the area of the joints is often severe, occurring in spasms and with the sensation of burning and tingling in the skin overlying the joints. After several months, once the individual is in the chronic stage, the signs of inflammation disappear and bony outgrowths (or Heberden’s nodes) begin to arise over the terminal interphalangeal joints of the fingers. At this time, the joints are generally painless, and the characteristic deformation associated with Heberden’s nodes becomes obvious.

2.Bouchard's nodes :

  • Bouchard's nodes are comparable in presentation to Heberden's nodes, but are significantly less common.
  • They are hard, bony outgrowths on the proximal interphalangeal joints (the middle joints of fingers or toes.)
  • They are also a sign of osteoarthritis, and are caused by formation of bony outgrowths .

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