赫伯登结节与骨关节炎潜在影像学改变之间的关系。
Relationship between Heberden's nodes and underlying radiographic changes of osteoarthritis.
作者信息
Thaper A, Zhang W, Wright G, Doherty M
机构信息
Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK.
出版信息
Ann Rheum Dis. 2005 Aug;64(8):1214-6. doi: 10.1136/ard.2004.031450. Epub 2005 Jan 27.
OBJECTIVE
To determine whether clinically determined Heberden's nodes (HN) and Bouchard's nodes (BN) are associated with underlying individual radiographic changes of osteoarthritis (OA).
METHODS
232 index patients with symptomatic large joint and/or hand OA, and 257 of their first degree relatives were included. HN were graded 0-2; BN were scored as present/absent. Joint space narrowing (JSN) and osteophyte (OST) were each scored 0-3 using the OARSI atlas. A weighted kappa test was used to examine intraobserver reproducibility. Odds ratio (OR) was estimated for the relationship between nodes and associated JSN and OST.
RESULTS
The adjusted OR of HN for underlying JSN in the same digit was 1.72 (95% CI 1.47 to 2.02), whereas for OST it was higher at 5.15 (95% CI 4.37 to 6.08). A similar trend was seen with BN and underlying OA, with OST having a higher OR (OR = 2.98, 95% CI 2.55 to 3.47) than JSN (OR = 1.62, 95% CI 1.37 to 1.91).
CONCLUSION
There is a positive relationship between HN/BN and underlying radiographic changes of OA, especially OST. Nodes do appear to link pathologically to OA in interphalangeal joints.
目的
确定临床诊断的赫伯登结节（HN）和布夏尔结节（BN）是否与骨关节炎（OA）潜在的个体影像学改变相关。
方法
纳入232例有症状的大关节和/或手部OA的索引患者及其257名一级亲属。HN分为0 - 2级；BN记录为存在/不存在。使用骨关节炎研究学会（OARSI）图谱将关节间隙变窄（JSN）和骨赘（OST）分别评为0 - 3分。采用加权kappa检验来检验观察者内的可重复性。估计结节与相关JSN和OST之间关系的比值比（OR）。
结果
同一手指中HN与潜在JSN的校正OR为1.72（95%可信区间1.47至2.02），而与OST的校正OR更高，为5.15（95%可信区间4.37至6.08）。BN与潜在OA也呈现类似趋势，OST的OR（OR = 2.98，95%可信区间2.55至3.47）高于JSN（OR = 1.62，95%可信区间1.37至1.91）。
结论
HN/BN与OA潜在的影像学改变之间存在正相关关系，尤其是与OST。结节在指间关节似乎确实与OA存在病理联系。
Zotero 插件