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Heberden's nodes linked to incidence, progression of knee OA
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The presence of Heberden’s nodes is associated with increased MRI-based periarticular bone area expansion related to knee osteoarthritis, according to findings published in Arthritis & Rheumatology.
“While there is no definitive standard definition or diagnostic criteria for generalized OA, [Herberden’s nodes (HNs)] are considered the hallmark and leading clinical manifestation of this entity,” Arya Haj-Mirzaian, MD, MPH, of the Johns Hopkins University School of Medicine, and colleagues wrote. “Large body of evidence introduced HNs as the main marker of generalized OA and leading predictor of knee OA. The potential role of HNs as prognostic factor for knee OA progression has been suggested by several reports. ... Despite all [this] evidence, the exact linkage between HNs and pathophysiology of knee OA is still unknown.”
To determine whether Heberden’s nodes can predict MRI-based knee OA-related osseous structural progression, the researchers analyzed data from the Foundation for the National Institute of Health project, a nested case-control study of 600 participants in the Osteoarthritis Initiative. Haj-Mirzaian and colleagues analyzed data from 575 participants, after excluding 25 patients with a self-reported prior history of gout.
The presence of Heberden’s nodes were examined at baseline, and knee MRIs were conducted at baseline and 24 months, in all participants. The researchers reviewed the MRIs based on semiquantitative MRI Osteoarthritis Knee Score (MOAKS) and quantitative periarticular bone morphology measures. In addition, they used adjusted linear and logistic regression models to determine the links between Heberden’s nodes at baseline and the progression of MRIdefined osseous structural damages.
According to Haj-Mirzaian and colleagues, 395 participants had Heberden’s nodes and 188 did not. Patients who demonstrated Heberden’s nodes had more periarticular bone area expansion in knee joints (adjusted OR = 1.39; 95% CI, 1.06-1.83) over 24 months. This result was particularly evident in the medial (aOR = 1.49; 95% CI, 1.05-2.13) and lateral (aOR = 2.51; 95% CI, 1.58-3.97) femur, as well as the femoral notch (aOR = 1.37; 95% CI, 1.07-1.84) and the lateral trochlea (aOR = 1.44; 95% CI, 1.08-1.9).
However, the researchers also observed a trend of lessening osteophyte progression among patients with Heberden’s nodes, compared with those without, in the whole knee joint (aOR = 0.63; 95% CI, 0.4-1.02), especially in the femur region (aOR = 0.54; 95% CI, 0.31-0.95).
“We found an association between the presences of HNs with periarticular bone area expansion over 24-months MRIs, whereas a trend of less worsening of osteophyte in HN+ subjects when compared to HN–, focused in the femoral region of knee joint,” Haj-Mirzaian and colleagues wrote. “More focused investigations in future studies with matched design may elucidate exact pathophysiology.” – by Jason Laday
Disclosure: Haj-Mirzaian reports no relevant financial disclosures. Please see the study for all other additional relevant financial disclosures.
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