Heberden's node
The Heberden's arthrosis, named after the London physician William Heberden (1710-1801), is an idiopathic osteoarthritis of the Fingerendgelenke ( distal interphalangeal, DIP) with formation of Heberden's nodes. The disease is primarily genetic, but also hormonal.
Clinical picture
Characteristic are the Heberden's nodes. These are two-humped, cartilaginous - bony growths on the extensor side of the base of the Fingerendglieder. They are often accompanied by significant local inflammatory and destructive phenomena: Gelenkverplumpung and deviation from the thumb side, pain, loss of strength, movement restriction.
The Heberden's arthritis often affects the end joints of the index finger and little finger. Often, the proximal interphalangeal joints ( proximal interphalangeal, PIP; Bouchard arthritis ) are - then referred to as Heberden's Bouchard's osteoarthritis - and thumb saddle joint (→ rhizarthrosis ) affected. Are other joints or the spine affected, it is called a polyarthritis.
Epidemiology
The Heberden's arthritis affects about ten times more women than men. Usually the disease begins in the menopause. Of 100,000 women between 50 and 59 years, an estimated 190 a year on one hand osteoarthritis, 100,000 men in the same age group, only 27 affected.
Diagnosis
It is a so-called visual diagnosis. The presence of Heberden's nodes is a characteristic other than an X-ray image further testing is usually not necessary. Prior to such synovectomy usually a bone scan is made.
The Heberden's arthritis must be distinguished above all in the differential diagnosis of chronic polyarthritis. In addition to the clinical picture and the X-ray image of the hands certain blood tests and possibly a three-phase skeletal scintigraphy may be necessary here in rare cases. Other differential diagnoses include gout arthropathy and psoriatic arthritis.
Therapy
For the therapy of pain relievers ( especially the joint stiffener, arthrodesis ) and the RSO are ( analgesics ), cortisone injections into the joint operational procedures. In addition, physiotherapy, occupational therapy, physical therapy (in particular cold application) and x-ray irradiation stimulus are used.
- Disease in orthopedic and trauma surgery