Heberden's Nodes: The Incidence of Hypertrophic Arthritis of the Fingers

Stecher, Robert M.

doi:10.1056/nejm194002222220802

Cited by 65 publications

(55 citation statements)

References 8 publications

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“…How ever, our fi ndi ng agrees w i th earl y studi es on the heredi ty of Heberden's nodes. 14,15 Based on earl i er studi es there i s a hi gher preval ence of mul ti pl e joi nt OA i n subjects w i th Heberden's nodes than i n those w i thout Heberden's nodes. A l so, i n the pol yarti cul ar Tabl e 3 Reported preval ence of physi ci an-di agnosed osteoarthri ti s (OA ) of speci fi c joi nts among the 560 tw i n subjects respondi ng to the questi onnai re i n 1996 Tabl e 4 Occurrence of OA i n the parents and non-tw i n si bl i ngs of the tw i n subjects accordi ng to the affected joi nt i n the tw i n subjects a % of the subjects abl e to respond to the speci fi c questi on on the occurrence of OA i n mother, father or non-tw i n si bl i ng.…”

Section: Discussionmentioning

confidence: 99%

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Joint-specific twin and familial aggregation of recalled physician diagnosed osteoarthritis

Kujala¹,

Leppävuori

Kaprio

et al. 1999

Twin res.

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I n our thr ee-stage questi onnai r e study w e i nvesti gated patter ns of tw i n and familial aggregation of osteoar thr i ti s (OA ) for commonl y affected joi nts. The basel i ne questi onnai r e study of the Fi nni sh Tw i n Cohor t w as per for med i n 1975. I n 1990, 4095 tw i n pai r s of the same gender bor n 1930-1957 r esponded to a questi onnai r e and r epor ted w hether they had OA di agnosed by a physi ci an. I n 1996 both tw i ns of 266 pai r s of w hi ch at l east one had r epor ted OA i n 1990 r esponded to a detai l ed questi onnai r e on joi nt-speci fi c OA , i ncl udi ng fami l y hi stor y of OA . I n mal e pai r s shar ed (nongenetic) familial effects accounted for 37% of the total var i ance i n l i ability to OA and unshared envi r onmental effects for 63%. I n femal e pai r s addi ti ve gene effects expl ai ned 44% of the var i ance in liability to OA, and unshared environmental effects for 36%. Familial aggregation of finger and k nee OA w as cl ear l y hi gher than that of hi p OA . Tw i n-pai r di scor dance for OA w as, to some extent, associ ated w i th body-mass i ndex, occupati onal l oadi ng and tr auma. Our r esul ts i ndi cate that geneti c effects may be modul ated by sex or by envi r onmental factor s di str i buted di ffer entl y betw een men and w omen. Based on our joi nt-speci fi c data fi nger and k nee joi nts ar e the most opti mal tar gets for studi es of geneti c factor s pr edi sposi ng to the devel opment of OA .Keyw or ds: osteoarthri ti s, epi demi ol ogy, geneti cs, tw i n research I ntr oducti on The suspected ri sk factors for osteoarthri ti s (OA ) i ncl ude geneti c predi sposi ti on, 1-3 obesi ty, 4,5 previ ous i njuri es, 5-7 and vari ous physi cal l oadi ng condi ti ons. 4,[8][9][10]

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Section: Discussionmentioning

confidence: 99%

“…Previ ous studi es have show n hi gh familial aggregati on of Heberden's nodes. 14,15 The presence of Heberden's nodes w as show n to be strongl y associ ated w i th pol yarti cul ar pri mary OA . 16 Based on earl i er studi es i t al so seems that familial aggregati on of hand and knee OA i s hi gher than that of hi p OA .…”

Section: Introductionmentioning

confidence: 99%

Joint-specific twin and familial aggregation of recalled physician diagnosed osteoarthritis

Kujala¹,

Leppävuori

Kaprio

et al. 1999

Twin res.

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“…Hand OA has a signifi cant heredity, indicating the presence of a genetic risk factor (Stecher 1941, Spector et al 1996 (Figure 10). The only previous study investigating an association between hand OA and knee OA in individuals who had undergone meniscectomy, as a human model of isolated joint damage, was published in the early 1980s (Doherty et al 1983).…”

Section: Knee Oa After Meniscal Injury Is Not Secondary Oa Onlymentioning

confidence: 99%

Meniscal tear - a feature of osteoarthritis

Englund¹

2004

SORT

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Meniscectomy is recognized as an important risk factor for the development of knee osteoarthritis (OA), a disease that traditionally has been considered as a simple "wear and tear" phenomenon. However, despite numerous reports, little evidence has been presented that a limited meniscal resection, compared with a more extensive resection, reduces the risk of OA by preserving meniscal function. Why? This thesis provides one possible answer to that question.Patients, who had undergone isolated meniscal resection in 1973, 1978, or between 1983 and 1985 at Lund University Hospital, Sweden, were reviewed clinically and radiographically 15-22 years after the surgical procedure.Of the subjects (n = 317) almost 50% had developed radiographic OA in their operated knee, but just over half of these patients were symptomatic. An additional 20% of the patients had knee symptoms, but did not have radiographic knee OA. These results confi rm a limited correlation between radiographic features of the disorder and symptoms.A degenerative type of meniscal tear and obesity were the factors most strongly associated with both radiographic knee OA and symptomatic radiographic knee OA.Partial meniscal resection induced less radiographic changes related to knee OA compared with total meniscectomy, but the patient-relevant outcomes remained essentially the same.If radiographic hand OA was present there was an increased likelihood of the patient also having knee OA following meniscectomy. This fi nding was independent of age, and therefore an inherited susceptibility to the disease contributes to the risk of knee OA after meniscal tear. Genetic and environmental risk factors interact in OA development.A degenerative meniscal lesion is often associated with early-stage knee OA, a disorder also involving the meniscal tissue. The tear may thus represent the fi rst "signal" feature of OA. The challenge for the health professional is to discriminate between symptoms caused by a meniscal tear and those caused by OA. Meniscal resection may not benefi t the patient with early-stage knee OA. The intervention merely removes evidence of the disorder, while the OA joint degradation proceeds.

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“…Polyarticular hand OA has been suggested as a marker for generalized primary OA and shows marked heritability (10)(11)(12)(13)(14)(15). Further studies on the association between hand OA and OA of the knee following meniscectomy might thus provide valuable information.…”

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confidence: 99%

Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy

Englund¹,

Paradowski²,

Lohmander³

2004

Arthritis & Rheumatism

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Objective. To evaluate the association between radiographic hand osteoarthritis (OA), a disease with marked heredity, and radiographic knee OA in patients treated with meniscectomy.Methods. We retrospectively identified 170 patients (mean age 54 years [range 33-87 years], 23% women) who had undergone isolated meniscectomy an average of 20 years earlier (range 17-22 years). Patients with cruciate ligament injury were excluded. All subjects were examined by standardized knee and hand radiography. Individual joints were considered to have OA when displaying radiographic features corresponding to a Kellgren/Lawrence (K/L) grade >2. Hand OA was considered present if at least 1 of the following criteria was fulfilled: the presence of radiographic OA (K/L grade >2) in at least 1 interphalangeal joint in each hand symmetrically, or in at least 2 distal or proximal interphalangeal joints in the same hand in a pattern consistent with primary OA (in the same row or ray), or in the first carpometacarpal joint bilaterally. The association between radiographic hand OA and radiographic knee OA was evaluated using logistic regression.Results. Radiographic hand OA was present in 57 patients (34%) and radiographic knee OA was identified in 105 patients (62%), within 94 index knees (55%) and 47 contralateral knees (28%). In a multivariate model, radiographic hand OA was associated with an increased likelihood of radiographic OA in the index knee (odds ratio [OR] 3.0, 95% confidence interval [95% CI] 1.2-7.5) and in the nonoperated contralateral knee (OR 3.5, 95% CI 1.0-12.2).Conclusion. The presence of radiographic hand OA is associated with an increased frequency of radiographic knee OA after meniscectomy. This finding confirms and extends that of a single previous study showing an interaction between hereditary and environmental risk factors for OA, a common and genetically complex disease. Accordingly, the development of OA following a meniscal tear and the resulting meniscal surgery should not be regarded to be of secondary origin only.

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Heberden's Nodes: The Incidence of Hypertrophic Arthritis of the Fingers

Cited by 65 publications

References 8 publications

Joint-specific twin and familial aggregation of recalled physician diagnosed osteoarthritis

Joint-specific twin and familial aggregation of recalled physician diagnosed osteoarthritis

Meniscal tear - a feature of osteoarthritis

Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy

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