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© 1992 British Society for Rheumatology

research-article

THE PREVALENCE OF PALPABLE FINGER JOINT NODULES IN DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS (DISH). A CONTROLLED STUDY

P. SCHLAPBACH*,, CH. BEYELER*, N. J. GERBER*, SJ. VAN DER LINDEN*, U. BÜRGI{dagger}, W. A. FUCHS{ddagger} and H. EHRENGRUBER§

*Department of Rheumatology, University of Berne Inselspital, 3010 Berne, Switzerland
{dagger}Department of Internal Medicine, University of Berne Inselspital, 3010 Berne, Switzerland
{ddagger}Department of Radiology, University of Berne Inselspital, 3010 Berne, Switzerland
§Department of Data Processing, University of Berne Inselspital, 3010 Berne, Switzerland

Correspondence to: Correspondence to P. Schlapbach, Department of Rheumatology, University of Berne, Inselspital, CH-3010 Berne, Switzerland

The presence of clinically palpable finger joint nodules a(Heberden's and Bouchard's nodes) was documented in 123 consecutive cases with diffuse idiopathic skeletal hyperostosis (DISH) of the thoracic spine and 191 matched DISH negative controls. The prevalence of palpable finger joint nodules was almost twice as frequent in cases with spinal DISH compared to controls (46% versus 31%, X2 = 7.67, P<0.01; multivariate adjusted odds ratio OR = 1.84; 95% CI: 1.14–2.98). This increase was most marked at the proximal interphalangeal joint, in males and in patients up to the age of 65 years. In addition and independent of other variables such as hyperostotic features, age and sex, the prevalence of palpable finger joint nodules was about twice as high in probands with a history of physically heavy work compared to those without (43% ver sus 26%, X = 9.18, P<0.005; multivariate adjusted odds ratio OR = 2.10; 95% CI: 1.26–3.52). From these results we con clude that DISH should be considered as an independent risk factor in the development of finger joint nodules.

KEY WORDS: Heberden's nodes, Diffuse idiopathic skeletal hyperostosis (DISH), Controlled study


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