Heberden’s nodes show in finger joints and may also be an indicator of unseen osteoarthritis in the knees.
A type of finger joint swelling long known to be a sign of osteoarthritis also could be a sign of arthritic damage in the knees.
Heberden’s nodes are bony growths that occur on the joints closest to the fingertips. They contribute the gnarled look of arthritic hands.
Heberden’s nodes typically form after the cartilage between finger joints is worn away due to osteoarthritis.
With the cartilage gone, bone rubs on bone, leading to bone loss. When the body tries to grow replacement bone on the disrupted joint, it often forms the pea-sized nodes.
Knee osteoarthritis lacks any such obvious markers, but Dr. Arya Haj-Mirzaian, MPH, says joint swelling in the fingers may be a predictor of similar damage occurring in the knees.
“The presence of (the nodes) in a physical examination is associated with a distinct pattern of worsening of osteoarthritis-related structural damage in the knee joint,” said Haj-Mirzaian, a postdoctoral fellow at Johns Hopkins University School of Medicine in Maryland and lead author of a study linking the two conditions that was published in the journal Arthritis & Rheumatology.
Haj-Mirzaian told Healthline the findings could help doctors diagnose generalized osteoarthritis even when symptoms appear limited to the joints of the hands.
He also suggested the findings could point to a new subcategory of osteoarthritis specific to people with Heberden’s nodes as a marker for systemic disease.
“Osteoarthritis isn’t a simple disorder,” said Haj-Mirzaian. “There are many different causes, including trauma, gout, genetics — they’re all totally different. Our research shows that we need to study arthritis based on (the nodes).”
He noted the nodes may affect the hips and other joints as well.
In fact, research dating back to 1989 suggests a possible relationship between Heberden’s nodes and osteoarthritis in the hips.
The new study included 395 patients with Heberden’s nodes and 188 without the visible joint swelling.
Researchers said they found significant associations between the presence of Heberden’s nodes and imaging measures of knee osteoarthritis.
The latest study, which included MRI exams of patients, builds on a 2018 study by Haj-Mirzaian and colleagues that found similar associations using X-rays and physical exams of the knee.
Specifically, the researchers found more periarticular bone expansion in the knee joint in patients with Heberden’s nodes, especially the region of the femoral joint.
However, the 24-month study also found that the Heberden’s nodes group appeared to have less development of osteophytes — commonly known as “bone spurs” — in the same area of the knees.
Dr. David Clark Hay, an orthopedic hand and wrist surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, told Healthline that the correlation between arthritis at two different sites on the body is interesting and merits further research.
“The study suggests a connection between [Heberden’s nodes] and periarticular bone expansion, but it is not clear what the clinical consequence would be, particularly when considered in conjunction with their finding of less worsening in osteophyte score,” Hay said. “The study suggests a future line of investigation into the underlying mechanism; might the same underlying genetic/biologic process that drives [Heberden’s nodes] formation in the hand be related to the periarticular joint expansion in the knee, but differ from the mechanism driving osteophyte formation?”
Dr. Enrico Villanueva, an orthopedic surgeon and an osteoarthritis expert at The Centers for Advanced Orthopaedics in Maryland, said it has long been known that Heberden’s nodes tends to run in families.
“Some people are predisposed to Bouchard’s nodes (which show up on the middle joint of the fingers) or Heberden’s nodes,” Villanueva told Healthline. “There certainly could be a genetic link to these changes.”
Villanueva said it is “certainly logical” to suspect that people with Heberden’s nodes may also have arthritis in parts of their body other than their hands.
“When an orthopedist detects osteoarthritis, we tend to make a full examination because we don’t want to miss an opportunity to detect something sooner and begin treatment,” he said.
Bony bumps in finger joints known as Heberden’s nodes may be a sign of osteoarthritis in the knees as well as the hands.
The research may point to a type of arthritis specific to people who have the nodes.
The findings may help with diagnosis of systemic osteoarthritis as well as helping researchers design studies that better target various populations and types of arthritis.