Osteoarthritis of the Hand

ByDavid R. Steinberg, MD, Perelman School of Medicine at the University of Pennsylvania
Reviewed/Revised May 2024
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Hand involvement is extremely common in osteoarthritis.

(See also Overview and Evaluation of Hand Disorders.)

Osteoarthritis affecting the hand may include asymptomatic enlargement of nodules at the proximal interphalangeal joint (Bouchard nodes) or distal interphalangeal joint (Heberden nodes) or angulation at these joints. Pain and stiffness of these joints and the base of the thumb are also common. The wrist usually is spared (unless there was preexisting trauma), and there is usually minimal or no metacarpophalangeal joint involvement unless the patient also has a metabolic disorder (eg, hemochromatosis).

Differentiation of hand changes in osteoarthritis from those in rheumatoid arthritis is discussed in Evaluation of the Patient With Joint Symptoms. Gout can affect the distal interphalangeal joints of the hand and should be distinguished from nodal hand osteoarthritis.

Examples of Finger Nodes
Heberden Nodes (Osteoarthritis)
Heberden Nodes (Osteoarthritis)

This photo shows Heberden nodes, hard-tissue (bony) prominences of distal interphalangeal joints seen in patients with osteoarthritis.

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DR P. MARAZZI/SCIENCE PHOTO LIBRARY

Heberden Nodes
Heberden Nodes

Heberden nodes are hard-tissue (bony) prominences of distal interphalangeal joints, seen best in this image on the 2nd and 3rd digits of both hands.

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By permission of the publisher. From Myers S: Atlas of Rheumatology. Edited by G Hunder. Philadelphia, Current Medicine, 2005.

Bouchard Nodes
Bouchard Nodes

Bouchard nodes are hard-tissue (bony) prominences of proximal interphalangeal joints, which in this photo are seen best on the digits of the right hand and the 1st and 2nd digits of the left hand.

... read more

© Springer Science+Business Media

Treatment of Osteoarthritis of the Hand

  • Conservative measures

  • Occasionally corticosteroid injection or surgery

Treatment of osteoarthritis of the hand is symptomatic with analgesics (particularly topical and oral nonsteroidal anti-inflammatory drugs), appropriate rest, splinting, and occasionally corticosteroid injection as needed.

Surgical procedures can help relieve pain and correct deformity for severe changes at the base of the thumb and, less commonly, for advanced degeneration of the interphalangeal joints.

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