Heberden's Nodes Predict Knee OA Progression

A recent study published in Arthritis & Rheumatology discovered that Heberden’s nodes (HNs) may be predictive of progression of knee osteoarthritis (OA).

“Heberden’s nodes (HNs) are bony enlargements of the finger joints that are readily detectable in a routine physical exam and are considered hallmarks of osteoarthritis,” explains a press release for the study.

The study included 575 patients from the Foundation for the National Institute of Health (FNIH) project. Evaluation of HNs and knee MRI were both conducted at baseline and after two years. MRIs were interpreted using semi‐quantitative MRI Osteoarthritis Knee Score (MOAKS) and quantitative periarticular bone morphology measures.

Of the total cohort, 395 patients had HN, and 180 did not. HNs patients were more likely to be female and older. They also had lower incidence of knee OA factors like injury and higher body mass index.

Over a 24-month period, the HN patients exhibited bone area expansion in the knee joint (adjusted odds ratio [aOR] [95%CI]: 1.39 [1.06–1.83]). This was particularly notable in the medial femur (aOR [95%CI]: 1.49 [1.05–2.13]) and lateral femur (aOR [95%CI]: 2.51 [1.58–3.97]), femoral notch (aOR [95%CI]: 1.37 [1.02–1.84]) and lateral trochlea (aOR [95%CI]: 1.44 [1.08 ‐ 1.9]).

When comparing the two groups, HN patients had less osteophyte worsening in the whole knee joint (aOR [95%CI]: 0.63 [0.40‐1.02]), notably in femur region (aOR [95%CI]: 0.54 [0.31‐0.95]).

“The presence of Heberden’s nodes in a physical examination is associated with a distinct pattern of worsening of osteoarthritis-related structural damage in the knee joint,” said study author Dr. Arya Haj-Mirzaian, of the Johns Hopkins University School of Medicine, in the release.

Fellow author Dr. Shadpour Demehri said, “These exploratory results have motivated us to initiate more focused investigations to further characterize the nodal osteoarthritis phenotype and tailor specific treatments for patients in future trials.”

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Source: Arthritis & Rheumatology