title: Investigations in generalized osteoarthritis. Part 2: special histological features in generalized osteoarthritis (histological investigations in Heberden's nodes using a histological score).
abstract: OBJECTIVE
  In accordance with the literature, our previous epidemiological, clinical and genetical investigations have confirmed a correlation between generalized osteoarthritis (GOA) and Heberden's nodes. Heberden's nodes can be considered as genetic markers for the existence of a generalized osteoarthritic predisposition. The present study's concern was to establish whether there are special histological features in this disease.
  
  
  METHODS
  Layered sections of 218 distal finger joints from 56 deceased persons were investigated using a histological-histochemical score modified by Mankin.
  
  
  RESULTS
  In Heberden's nodes, we found all the typical degradative sequences of the osteoarthritic process but also some specific modifications. The osteoarthritis (OA) starts with a subchondral ossification and manifests a reactive tidemark flaking. At this time, the surface of the cartilage is not yet destroyed. Later on, there is progression of general degradation. Significant differentiation from the control group is possible using a histological score.
  
  
  CONCLUSIONS
  In patients with Heberden's nodes, the OA starts with the subchondral ossification. Heberden's nodes are the specific manifestation of GOA in the distal finger joints. Further studies are therefore required to assess whether the same pathogenetic mechanism can be seen in OA of the large joints in GOA.
authors.affiliation: Department of Orthopedic Surgery, Marienstift Arnstadt, Wachsenburgallee 12, D-99310 Arnstadt, Germany. irlenbusch@ms-arn.de
authors.forename: U
authors.initials: U
authors.lastname: Irlenbusch
authors.forename: G
authors.initials: G
authors.lastname: Dominick
mesh_terms: D017677:Age Distribution; D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000473:pathology; D002358:Cartilage, Articular / Q000473:pathology; D018450:Disease Progression; D005260:Female; D005384:Finger Joint / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000150:complications / Q000473:pathology; D010003:Osteoarthritis / Q000150:complications / Q000473:pathology*