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The prevalence of palpable finger joint nodules in diffuse idiopathic skeletal hyperostosis (DISH). A controlled
P Schlapbach1, C Beyeler, N J Gerber
1Department of Rheumatology, University of Berne, Inselspital, Switzerland.
Insights
Diffuse idiopathic skeletal hyperostosis (DISH) is linked to a higher prevalence of finger joint nodules. Physically demanding work also increases the risk of developing these nodules in individuals with DISH.
Area of Science:
- Rheumatology
- Orthopedics
- Epidemiology
Background:
- Finger joint nodules, specifically Heberden's and Bouchard's nodes, are common clinical findings.
- Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by calcification and ossification of ligaments and entheses, primarily affecting the spine.
Purpose of the Study:
- To investigate the association between diffuse idiopathic skeletal hyperostosis (DISH) of the thoracic spine and the presence of palpable finger joint nodules.
- To determine if DISH is an independent risk factor for developing finger joint nodules.
Main Methods:
- A case-control study was conducted involving 123 patients with spinal DISH and 191 matched controls without DISH.
- Palpable finger joint nodules were documented, and statistical analyses, including chi-squared tests and multivariate logistic regression, were performed to assess associations.
Main Results:
- The prevalence of palpable finger joint nodules was significantly higher in patients with spinal DISH (46%) compared to controls (31%).
- This association was particularly pronounced at the proximal interphalangeal joints, in males, and in individuals up to 65 years of age.
- A history of physically heavy work was independently associated with an increased prevalence of finger joint nodules (43% vs. 26% in DISH patients).
Conclusions:
- Diffuse idiopathic skeletal hyperostosis (DISH) is an independent risk factor for the development of finger joint nodules.
- The findings suggest a potential link between DISH, occupational factors, and the manifestation of peripheral skeletal changes.
Abstract:
The presence of clinically palpable finger joint nodules (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%, chi 2 = 7.67, P less than 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% versus 26%, chi = 9.18, P less than 0.005; multivariate adjusted odds ratio OR = 2.10; 95% CI: 1.26-3.52). From these results we conclude that DISH should be considered as an independent risk factor in the development of finger joint nodules.