Which disease is associated with hard non tender Heberden and Bouchard nodes?

Arthritis is a group of more than 100 conditions that cause inflammation or swelling in your joints. Many of these types of arthritis can develop in the joints between your finger bones.

The most common form of arthritis is called osteoarthritis. It usually develops after years of wear and tear on a joint causes the cartilage to break down.

One of the classic signs of osteoarthritis in the middle joint of a finger is the formation of bumps called Bouchard nodes. The presence of Bouchard nodes can help differentiate osteoarthritis from other types of arthritis that can affect your hands, like psoriatic arthritis.

Keep reading to learn more about Bouchard’s nodes, including why they develop and why they’re an important part of an arthritis diagnosis.

One of the biggest challenges in diagnosing arthritis of the finger joints is differentiating between osteoarthritis and psoriatic arthritis.

The presence of Bouchard’s nodes is a classic sign of hand osteoarthritis that can help with this differentiation. They’re named after the French doctor Charles-Joseph Bouchard.

Bouchard’s nodes are hard, bony bumps that form along the middle joints of your fingers. These joints are called your proximal interphalangeal joints.

Bouchard’s nodes can cause:

• swelling and stiffness
• weakness
• crooked fingers
• decreased range of motion

You can develop Bouchard’s nodes in one or many fingers. They’re called Heberden’s nodes when they form on the joints near the end of your fingers, which are called your distal phalangeal joints.

Bouchard’s nodes are less common and are associated with more severe arthritis.

Bouchard’s nodes form when the cartilage between your finger bones wears down. The role of this cartilage is to reduce friction in your joints. When it wears away, your bones start to rub together. This can damage the joint and trigger the development of new bony tissue.

New bone tissue can cause the ends of your fingers to become misaligned and crooked.

Risk factors for the development of hand osteoarthritis include:

• older age
• prior injury
• working a job that requires a lot of hand movement
• having a family history of Bouchard’s nodes

About 1 in 4 people with psoriasis also have psoriatic arthritis, which can cause joint pain, swelling, and stiffness.

Psoriatic arthritis tends to develop 5 to 10 years after a psoriasis diagnosis.

But people with psoriasis can also develop other types of arthritis, like osteoarthritis, and differentiating between them can be difficult.

In a 2021 study published in the Journal of Rheumatology, researchers found that the prevalence of osteoarthritis was:

• 22 percent in people with psoriatic arthritis
• 12.6 percent in people with psoriasis
• 11 percent in the general population

Osteoarthritis is caused by a degeneration of the cartilage in your joints from repetitive wear and tear. Psoriatic arthritis is caused by joint damage from your immune system attacking healthy cells. People with psoriasis can develop both types of arthritis.

Psoriatic arthritis

Psoriatic arthritis is caused by a misdirected immune response where your immune system attacks your joints. Symptoms can range from mild to severe. Symptoms depend on where your arthritis develops, but they can include:

• stiffness
• swelling
• pain
• nail pitting or separation
• scaly skin patches

You may go through flare-ups or periods when your symptoms are worse than usual. Some people have severe problems with many joints, and other people have mild symptoms in only one or two joints.

The development of psoriatic arthritis still isn’t fully understood. Between one-third and one-half of people with psoriatic arthritis also have a relative with psoriasis or psoriatic arthritis. It most commonly develops between the ages of 30 to 50.

Osteoarthritis

Osteoarthritis is the most common type of arthritis, and it becomes more common with age. In the United States, it’s estimated that 80 percent of people over age 65 have signs of osteoarthritis.

Osteoarthritis is caused by the wear and tear on joints that happens over the course of many years. It tends to develop slowly and gets worse over time as the joint continues to sustain damage.

There’s no cure for osteoarthritis, but treatment can help manage your symptoms.

Symptoms are similar to those of other types of arthritis and include:

• pain
• stiffness
• loss of mobility
• swelling
• popping or crackling joints

Psoriatic arthritis commonly affects the hands. It can also appear in the knees, ankles, and feet.

Symptoms of psoriatic arthritis in the hands are similar to other types of arthritis. They can include:

• redness and swelling
• decreased range of motion
• stiffness
• heat coming from the affected joint

Your hands might not be affected evenly. Swelling often affects a whole finger with the most swelling around your middle knuckle. The joint at the end of your finger may also be deformed.

You may notice changes to the texture of your fingernails such as pitting, ridging, or crumbling.

About 23 to 27 percent of people with psoriasis develop symptoms on their nails.

Some people with psoriatic arthritis may also have areas of red, dry, and scaly skin on their hands or palms. Psoriasis can develop on any part of your body but most commonly affects your:

• elbows
• knees
• scalp
• lower back
• belly

While there’s no particular treatment for Bouchard’s nodes, your doctor can help you manage other symptoms of arthritis in your hands.

Treatment for arthritis usually starts with a conservative, noninvasive approach. Your doctor may suggest:

• medications. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) or other medications like capsaicin. Medications are available in different forms such as creams, lotions, and pills.
• changing movement habits. You may experience pain relief by adapting your hand movements and avoiding movements that cause pain.
• heat and cold. Some people experience pain relief when they apply heat and cold to the affected joint.

If medication and other conservative treatments fail, your doctor may recommend surgery. But surgery performed to repair hand arthritis is uncommon because the complication and failure rates are high.

The two primary surgeries used to treat arthritis of the hand include:

• joint replacement. Your damaged joint is removed and replaced with an artificial implant.
• joint fusion. The bones on either side of your finger are fused together to reduce movement through your joint.

Hand arthritis can negatively impact your quality of life. You may be able to reduce your discomfort with a combination of home remedies and changing your movement habits.

Here are some tips to make living with hand arthritis easier:

• Use utensils with a wide handle to avoid needing to squeeze tightly.
• Avoid extra pressure on your fingers during tasks like opening and closing doors. Use your palms when possible.
• Hold your phone or tablet with the palm of your hands. You can buy cases to make this easier.
• Use an ergonomic keyboard or try dictation software to minimize typing.
• Consider wearing a brace or splint to minimize movement through the joint.
• Ask your pharmacist for easy-open prescription medication bottles to minimize fine finger movement.
• Wear clothes that are easy to put on and take off. Consider buying clothes with magnetic buttons.
• Use shampoo and conditioner bottles with pumps instead of squeeze bottles.
• Minimize unnecessary tasks that use your hands and cause pain.
• Minimize how often you hold small objects with a tight grip for an extended amount of time.
• Avoid activities that you find particularly painful.

Bouchard’s nodes are one of the characteristic signs of osteoarthritis of the finger joints, not psoriatic arthritis. They appear as bony bumps along the middle joint of a finger. Doctors use the presence of these bumps to differentiate osteoarthritis from other types of arthritis.

Arthritis in your hands can be very uncomfortable, but your doctor can help you develop a treatment plan. Your doctor will likely first recommend conservative treatments like changing your movement habits or taking NSAIDs. If these don’t reduce your discomfort, they may recommend surgery.