An unusual case of Heberden nodes in a young man

Heberden nodes affect mainly middle-aged women. Inheritance is autosomal do minant in female and autosomal recessive in male patients. We report the case of a young man who presented already with 12 years of ag e with pain in the distal finger joints. There were no other clinical or se rological signs for other rheumatoid diseases, like psoriatic or rheumatoid arthritis. Radiologic findings were consistent with Heberden's osteoarthri tis of the finger joints. The joint changes remained clinically and radiolo gically stable during a time period of more than 15 years. The HLA typing r evealed the haplotype HLA Al, B8 and DR4, in accordance with former studies which reported a higher frequency of HLA Al, B8 in families with primary o steoarthritis (early onset osteoarthritis of the large joints in combinatio n with Heberden nodes).