Bouchard's nodes are growths of bone, cartilage or gelatinous cysts that enlarge and distort the proximal interphalangeal, or middle, joints of fingers or toes. These nodes give the joint a swollen appearance, with a considerably wider circumference than the rest of the digit and are an early sign of osteoarthritis. They take their name from Dr. Charles-Joseph Bouchard, a French pathologist of the late 19th century who studied arthritis extensively. Like the Heberden’s nodes that affect the smallest joints at the ends of the fingers and toes, Bouchard’s nodes might not be painful, but they often are accompanied by reduced movement of the joint.
The presence of Bouchard’s nodes can be invaluable in the diagnosis of osteoarthritis, especially in the earliest stages before the condition has become severe. Most osteoarthritis exams require laboratory tests such as X-rays or blood tests, but any doctor can identify Bouchard’s nodes quickly with simple observation. After osteoarthritis has been identified, the doctor might decide to use one or more of these laboratory tests to discover the extent and severity of the condition.
The causes of Bouchard’s nodes are not fully understood, but genetics does play a significant role, and a patient is more likely to develop these nodes if a parent or other relative has them. Most researchers believe that the nodes are caused by protrusions of cartilage and bone called osteophytes, which often develop at the site of a deteriorating joint and are associated with other signs of osteoarthritis. Agreement on this point, however, is not universal, and the source of Bouchard’s nodes is a point of dispute.
Osteoarthritis is not curable, but there are treatments available. This treatment focuses on preserving mobility, minimizing joint distortion and managing pain. In early stages, over-the-counter treatments might be sufficient, but as the condition progresses, non-prescription treatments might not be adequate. Food supplements or changes in diet also might be recommended. The presence of Bouchard’s nodes often allows early diagnosis and can prompt an early response, allowing the patient to manage the arthritis without resorting to more severe measures.
As the condition develops, prescription drugs might be considered, and depending on the severity of the arthritis, surgical procedures might be necessary. Cortisone injections can reduce inflammation and reduce pain in some cases. Surgical options include spur removal, joint fusion and even joint replacement. Patients should consult with a medical professional to discuss the best options.
