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Relation between Heberden's nodes and distal interphalangeal joint osteophytes and their role as markers of generalised disease.
Ann Rheum Dis. 1998 Apr; 57(4):246-8.AR

Abstract

OBJECTIVE

Heberden's nodes are often used as a marker for osteoarthritis (OA). This study examined how often Heberden's nodes and radiological distal interphalangeal (DIP) osteophytes coexist in the same digit and the sensitivity, specificity, and positive predicative value of each for OA at different sites or generalised disease.

METHODS

This was a population-based study of 660 middle ages women taking part in a twin study of OA. Distal interphalangeal osteophytes were defined radiologically and graded on a four point scale (0-3) using a published atlas of individual features. Heberden's nodes were defined by standardised clinical examination. OA in other joint (knees, proximal interphalangeal (PIP) joints and carpometacarpal (CMC) joints) was defined radiologically using a published atlas.

RESULTS

Poor agreement was observed between a Heberden's node (HN) and a radiological distal interphalangeal osteophyte in the same finger of the same hand (K statistic (95% CI) = 0.36 (0.33, 0.39)). Although HN and radiological DIP osteophytes had similar sensitivity, the specificity and positive predicative value of DIP osteophytes was considerably higher for detecting knee, CMC, PID OA, and OA in more than two groups of joint (knee, CMC, and DIP joints).

CONCLUSION

HN are not synonymous with DIP osteophytes. Radiological DIP osteophytes are a better marker of knee and multiple joint OA than HN. HN may still be an imperfect surrogate for hand OA when radiology is impractical, but are not an accurate marker of generalised disease.

Authors+Show Affiliations

Department of Epidemiology and Preventive Medicine, Monash University Medical School, Alfred Hospital, Prahran, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Twin Study

Language

eng

PubMed ID

9709182

Citation

Cicuttini, F M., et al. "Relation Between Heberden's Nodes and Distal Interphalangeal Joint Osteophytes and Their Role as Markers of Generalised Disease." Annals of the Rheumatic Diseases, vol. 57, no. 4, 1998, pp. 246-8.
Cicuttini FM, Baker J, Hart DJ, et al. Relation between Heberden's nodes and distal interphalangeal joint osteophytes and their role as markers of generalised disease. Ann Rheum Dis. 1998;57(4):246-8.
Cicuttini, F. M., Baker, J., Hart, D. J., & Spector, T. D. (1998). Relation between Heberden's nodes and distal interphalangeal joint osteophytes and their role as markers of generalised disease. Annals of the Rheumatic Diseases, 57(4), 246-8.
Cicuttini FM, et al. Relation Between Heberden's Nodes and Distal Interphalangeal Joint Osteophytes and Their Role as Markers of Generalised Disease. Ann Rheum Dis. 1998;57(4):246-8. PubMed PMID: 9709182.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relation between Heberden's nodes and distal interphalangeal joint osteophytes and their role as markers of generalised disease. AU - Cicuttini,F M, AU - Baker,J, AU - Hart,D J, AU - Spector,T D, PY - 1998/8/26/pubmed PY - 1998/8/26/medline PY - 1998/8/26/entrez SP - 246 EP - 8 JF - Annals of the rheumatic diseases JO - Ann Rheum Dis VL - 57 IS - 4 N2 - OBJECTIVE: Heberden's nodes are often used as a marker for osteoarthritis (OA). This study examined how often Heberden's nodes and radiological distal interphalangeal (DIP) osteophytes coexist in the same digit and the sensitivity, specificity, and positive predicative value of each for OA at different sites or generalised disease. METHODS: This was a population-based study of 660 middle ages women taking part in a twin study of OA. Distal interphalangeal osteophytes were defined radiologically and graded on a four point scale (0-3) using a published atlas of individual features. Heberden's nodes were defined by standardised clinical examination. OA in other joint (knees, proximal interphalangeal (PIP) joints and carpometacarpal (CMC) joints) was defined radiologically using a published atlas. RESULTS: Poor agreement was observed between a Heberden's node (HN) and a radiological distal interphalangeal osteophyte in the same finger of the same hand (K statistic (95% CI) = 0.36 (0.33, 0.39)). Although HN and radiological DIP osteophytes had similar sensitivity, the specificity and positive predicative value of DIP osteophytes was considerably higher for detecting knee, CMC, PID OA, and OA in more than two groups of joint (knee, CMC, and DIP joints). CONCLUSION: HN are not synonymous with DIP osteophytes. Radiological DIP osteophytes are a better marker of knee and multiple joint OA than HN. HN may still be an imperfect surrogate for hand OA when radiology is impractical, but are not an accurate marker of generalised disease. SN - 0003-4967 UR - https://www.unboundmedicine.com/medline/citation/9709182/Relation_between_Heberden's_nodes_and_distal_interphalangeal_joint_osteophytes_and_their_role_as_markers_of_generalised_disease_ L2 - https://ard.bmj.com/lookup/pmidlookup?view=long&pmid=9709182 DB - PRIME DP - Unbound Medicine ER -