The presence of Heberden nodes (HNs) may be associated with increased periarticular bone area expansion in the knee joint, according to study data published in Arthritis & Rheumatology.

Investigators abstracted data from the Foundation for the National Institute of Health project, a nested case-control study of participants in the Osteoarthritis Initiative cohort. Patients underwent clinical examination for the presence of HNs at baseline and at 24-month follow-up. Knee osteoarthritis-related structural damage was also assessed with magnetic resonance imaging (MRI) at the same time points. Investigators read MRI data per the semi-quantitative MRI Osteoarthritis Knee Score and quantitative assessment of periarticular bone morphology methods. Linear and logistic regression models were utilized to examine the association between HN positivity at baseline and subsequent worsening of MRI-defined osseous structural damages.

A total of 575 participants were included in the analysis; 395 had HN at baseline. Over 24 months, patients with baseline HN experienced greater periarticular bone area expansion in the knee joint (adjusted odds ratio [aOR], 1.39; 95% CI, 1.06-1.83) compared with patients without HN. This effect was particularly pronounced in the medial femur (aOR, 1.49; 95% CI, 1.05-2.13), lateral femur (aOR, 2.51; 95% CI, 1.58-3.97), femoral notch (aOR, 1.37; 95% CI, 1.02-1.84), and lateral trochlea (aOR, 1.44; 95% CI, 1.08-1.90). However, in patients with HN there was a trend toward less osteophyte worsening in the whole knee joint (aOR, 0.63; 95% CI, 0.40-1.02), particularly in the femur area (aOR, 0.54; 95% CI, 0.31-0.95), compared with patients without HN.

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These data suggest that the presence of HNs may be predictive of increased MRI-based periarticular bone area expansion. In addition, HN positivity may be associated with less osteophyte worsening over a 24-month period in the knee joint, particularly in the femoral area.

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Haj-Mirzaian A, Mohajer B, Guermazi A, et al. Heberden’s nodes and knee osteoarthritis-related osseous structural damage: exploratory study from the Foundation for the National Institute of Health [published online January 9, 2019]. Arthritis Rheumatol. doi:10.1002/art.40811