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Osteoarthritis of the HandAka: 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
  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)

ConceptsFinding (T033)
EnglishDISTAL INTERPHALANGEAL NODULE, HEBERDEN NODE, HEBERDEN NODES, Heberden's node, Heberdens' nodes, Tuberculum Arthriticum
Spanishnodulo de Heberden
Parent ConceptsExostoses (C1442903), Named sign of joint (C0575037), Finding of finger joint (C0575829), Ambiguous concept (C1274012)
SourcesDXP, NCI, OMIM, SCTSPA, SNOMEDCT
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.
ConceptsFinding (T033)
Parent ConceptsPhysical Examination (C0031809), Joint or joint related complaint (C0221585), Wrist(s) and/or Hand(s) (C0221592)
SourcesAIR
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.
ConceptsFinding (T033)
Parent ConceptsPhysical Examination (C0031809), Joint or joint related complaint (C0221585), Wrist(s) and/or Hand(s) (C0221592)
SourcesAIR
Derived from the NIH UMLS (Unified Medical Language System)


Osteoarthritis of the hand (C0263746)

ConceptsDisease or Syndrome (T047)
EnglishDegenerative joint disease of hand, HAND OSTEOARTHRITIS, HOA, Osteoarthritis - hand joint, Osteoarthritis of the hand
Spanishartrosis - articulacion de la mano, artrosis de la mano, osteoartritis - articulacion de la mano
Parent ConceptsArthropathies NOS (C0022408), Degenerative polyarthritis (C0029408), Duplicate concept (C1274013), Disorder of hand (C1290871)
SourcesMTH, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Bouchard's node (C0263780)

ConceptsDisease or Syndrome (T047)
EnglishBouchard's node, Bouchard's nodes, Bouchards' nodes
Spanishnodulo de Bouchard, nodulos de Bouchard
Parent ConceptsArthropathies NOS (C0022408), Finding of finger joint (C0575829), Disorder of finger (C1290036)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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