Rheumatology Book

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Osteoarthritis of the Hand

Aka: Osteoarthritis of the Hand, Hand Osteoarthritis, Heberden's Node, DIP Bony Joint Enlargement, Bouchard's Node, PIP Bony Joint Enlargement
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  1. See Also
    1. Osteoarthritis
    2. Knee Osteoarthritis
  2. Epidemiology
    1. Hand less commonly affected in Osteoarthritis
    2. Hand most disabling of joints to be involved
  3. Signs
    1. Most common site
      1. Trapeziometacarpal joint (base of thumb)
    2. Heberden's Nodes
      1. Distal interphalangeal joint (ITP) nodular swelling
    3. Bouchard's Nodes
      1. Proximal interphalangeal joint (PIP) nodular swelling
    4. Mucous cysts may develop at interphalangeal joints
    5. First Metacarpal-phalangeal joint (MCP) involvement
      1. Other MCP joints are generally spared
    6. Wrist spared
      1. Contrast with Rheumatoid Arthritis
  4. Diagnostic Criteria (American College Rheumatology)
    1. Hand pain, aching or stiffness and
    2. Two DIP or PIP joints with hard tissue enlargement and
    3. Less than 3 swollen MCP joints
    4. One of the following
      1. Two DIP joints with hard tissue enlargement or
      2. Deformity of two DIP, PIP, or MCP joints
    5. Altman (1990) Arthritis Rheum 33:1601-10
  5. Radiology
    1. See Hand XRay in Osteoarthritis
  6. Management
    1. NSAIDs
    2. Intermittent Splinting
    3. Moist heat
    4. Local Corticosteroid Injection
    5. Contrast Baths
    6. Surgery for resistant cases
      1. Arthroplasty
      2. Arthrodesis

Heberden's node (C0018862)

Concepts Finding (T033)
SnomedCT 371598009, 201821005, 86376005
English DISTAL INTERPHALANGEAL NODULE, HEBERDEN NODE, Heberden's nodes, HEBERDEN NODES, Heberden's nodes (physical finding), painless nodule on distal interphalangeal (DIP) joint, Heberden's nodes (painless nodules DIP), Heberden's nodes were seen, Heberden node, heberden nodes, Heberdens nodes, heberden's node, heberden node, heberden's nodes, heberdens node, Heberden's node, Heberden's node (finding), Heberden; node, node; Heberden, Heberden's node (disorder), Heberdens' nodes, Heberden's Node, Tuberculum Arthriticum, heberdens nodes
Dutch Heberden-knobbels, Heberden; nodus, nodus; Heberden
French Nodosités d'Heberden
German Heberden-Knoten
Italian Noduli di Heberden
Portuguese Nódulos de Heberden
Spanish Nódulos de Heberden, Heberdens' nodes, Heberden's node, nódulo de Heberden (hallazgo), nódulo de Heberden (trastorno), nódulo de Heberden
Japanese ヘバーデン結節, ﾍﾊﾞｰﾃﾞﾝｹｯｾﾂ
Czech Heberdenovy uzly
Hungarian Heberden-csomók
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Osteoarthritis of the hand (C0263746)

Concepts Disease or Syndrome (T047)
SnomedCT 156491002, 267896009, 22193007, 201891001, 287011007
English Osteoarthritis NOS, of the hand, Osteoarthritis NOS-hand, Osteoarthritis of the hand, osteoarthrosis of hand, osteoarthritis of hand, osteoarthritis of hand (diagnosis), osteoarthrosis of hand (diagnosis), Osteoarthritis NOS, of the hand (disorder), Osteoarthrosis of hand, hands osteoarthritis, hand osteoarthritis, osteoarthritis hand, Degenerative joint disease of hand, Osteoarthritis - hand joint, Degenerative joint disease of hand (disorder), Osteoarthritis - hand joint (disorder), Hand osteoarthritis
Dutch osteoartritis hand
French Ostéoarthrite des mains
German Osteoarthritis der Hand
Italian Osteoartrite della mano
Portuguese Osteartrite da mão
Spanish Artrosis de mano, Osteoarthritis - hand joint, Osteoarthritis NOS, of the hand, artrosis de mano, enfermedad articular degenerativa de mano, osteoartrosis de articulación de mano, enfermedad articular degenerativa de mano (trastorno), artrosis de la mano, artrosis de la mano (trastorno), artrosis - articulación de la mano (trastorno), artrosis - articulación de la mano, artrosis, SAI, de la mano (trastorno), artrosis, SAI, de la mano, osteoartritis - articulación de la mano (trastorno), osteoartritis - articulación de la mano
Czech Osteoartritida ruky
Japanese 変形性手関節症, ﾍﾝｹｲｾｲﾃｶﾝｾﾂｼｮｳ, ﾍﾝｹｲｾｲｼｭｶﾝｾﾂｼｮｳ
Hungarian Kéz arthrosis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


DIP joints: bony joint enlargement, Heberden's nodes (C0221635)

Definition (AIR) WHAT: Heberden's nodes. Heberden's Nodes: cartilaginous and bony enlargements of the distal interphalangeal joints of the fingers. WHY: The presence of Heberden's nodes is a common, characteristic physical finding of degenerative joint disease. HOW: Heberden's nodes are recognized by their characteristic location at the dorsolateral and medial aspects of the distal interphalangeal joints of the hand. They are usually nontender, painless, firm nodules 2 or 3 mm in diameter and are often associated with flexion and medial or lateral deviation of the distal phalanx. REFS: Bland, JH and Stulberg, SD: Osteoarthritis: Pathology and Clinical Patterns. In Kelley: Textbook of Rheumatology. W.B. Saunders Co., 1981, pp. 1478-80.
Concepts Finding (T033)
English DIP joints: bony joint enlargement, Heberden's nodes
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Bouchard's node (C0263780)

Concepts Disease or Syndrome (T047)
SnomedCT 20243008, 201821005
English Bouchard's nodes, painless nodules on PIP, Bouchard's nodes (physical finding), painless nodules on proximal interphalangeal joint (PIP), Bouchard's nodes were seen, Bouchard node, bouchard's node, bouchard's nodes, Bouchard's node, Bouchard's node (disorder), Bouchard; node, node; Bouchard, Bouchards' nodes
Dutch Bouchard-noduli, Bouchard; nodus, nodus; Bouchard
French Noeuds de Bouchard
German Bouchard-Arthrose
Italian Noduli di Bouchard
Portuguese Nódulos de Bouchard
Spanish Nódulos de Bouchard, nódulos de Bouchard, Bouchard's node, Bouchards' nodes, nódulos de Bouchard (trastorno), nódulo de Bouchard (trastorno), nódulo de Bouchard
Japanese ブシャール結節, ﾌﾞｼｬｰﾙｹｯｾﾂ
Czech Bouchardovy uzly
Hungarian Bouchard-csomók
Sources
Derived from the NIH UMLS (Unified Medical Language System)


PIP joints: bony joint enlargement, Bouchard's nodes (C0221636)

Definition (AIR) WHAT: Bouchard's nodes. Bouchard's Nodes: cartilaginous and bony enlargements of the proximal interphalangeal joints of the fingers. WHY: The presence of Bouchard's nodes is a common, characteristic physical finding of degenerative joint disease. HOW: Bouchard's nodes are recognized by their characteristic location at the dorsolateral and medial aspects of the proximal interphalangeal joints of the hand. They are usually nontender, painless, firm nodules 2 to 3 mm in diameter. REFS: Bland, JH and Stalberg, SD: Osteoarthritis: Pathology and Clinical Patterns. In Kelley: Textbook of Rheumatology. W.B. Saunders Co., 1981, pp. 1478-80.
Concepts Finding (T033)
English PIP joints: bony joint enlargement, Bouchard's nodes
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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