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Herbeden's nodes

I have not been diagnosed with PsA but have had tendonitis and joint pain for over 20 years. Last summer my right hand fingers suddenly became extremely painful and swollen...however, the swelling was not extreme like pictures I've seen of dactylitis. I couldn't bend my fingers at all and getting dressed was very difficult. A week later the left hand fingers followed. The flare eventually calmed down after lots of Advil, ice and Voltaren gel. During the flare, my fingers were throbbing especially behind my fingernails but I have had no nail changes. It felt like my hand had been slammed in a car door. Now my fingers have what look like Herbeden's nodes on them. I was referred to a rheumatologist who basically said he's not sure what this is but that the bumps on my DIP joints are Herbeden's nodes which are harmless, genetic and part of osteoarthritis. I'm confused - the bumps came after what seemed like a very inflammatory flare. I've read that it takes years to develop Herbeden's nodes. I didn't have any rashes at the time but mentioned that my mom has psoriasis and I had had what I thought was psoriasis on my elbows. A couple months later a dermatologist confirmed psoriasis on my knee and scalp.

Basically, I'm confused about the bumps on my fingers. They are tender especially during a flare - shaking hands is painful or if something brushes against those fingers they are painful. I feel like my doctor wrote them off as osteoarthritis but I'm positive they weren't there before the bad flare up last summer.

  1. BTW, I forgot to mention that this flare happened when I was 39 years old. (I just turned 40 recently). So I think I may be a little young to suddenly have Herbeden's nodes on my fingers overnight. Anyone else have these bumps?

    1. I think I have a couple ..... I thought they were like knots. I had them on the bottom of my foot near the balls of my feet...very sore. And I have one on my thumb and my forefinger. The finger has swollen twice in the past 8 years and it seemed after that I had the bump. My thumb didn't swell, but is sore and you can't really see the bump, but I feel it in there and it's sore to the touch.

  2. Hi


    I have these lumps on my elbows. They are getting very bad at the moment because of flaring up but exactly as you describe, very tender to any touch at all. I am 38 and have had PsA for 22 years and never heard of Hebendens nodes before this post.


    I am not under a derm anymore as Humira prescribed by my rheumatologist has dampened almost everything down, except these lumps on elbows (I had them on my knees more than a decade ago but they went when I started on my biologic)


    Anyway, I hope very much that it has resolved for you by now.
    Did you ever get a firm diagnosis of what the tender lumps actually were on your fingers? I will be speaking to my GP about it quite soon and a possibility or two what it could be would be very helpful.

    1. I hate when someone says just osteoarthritis like it is no big deal. It's very painful, and unlike PsA or RA there's no treatment to stop progression (yet). It is possible to have osteoarthritis and PsA at the same time. I have both and it was early onset like you. I was in my 30s too. The heberden nodes probably were there already but became more noticeable after your pain flare. My doctor told me that early onset osteoarthritis can be inflammatory in nature and genetic. There are 100s of types of arthritis and they are learning more everyday. I hope you get some relief. You can always get a second opinion.

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