Heberden’s & Bouchard’s nodes – Osteoarthritis

Definition: Heberden’s nodes are osteoarthritic nodules of the distal interphalangeal joints (DIPs).

Bouchard’s nodes are osteoarthritic nodules at proximal interphalangeal joints (PIPs).

Causes: Due to formation of osteophytes on interphalangeal joints in osteoarthritis.

Examination: Examine patient’s hands carefully, specifically the interphalangeal joints. Nodules are generally a few millimetres in diameter. Both nodes are usually painless. Node formation is gradual leading to some loss of movement but function is less affected. Nodes are usually bilateral but larger on the patient’s dominant side (i.e. on right hand if right-handed).

*Erratum:  The spelling of Heberden’s nodes on the image is incorrect.