Osler node
Osler node | |
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Osler node on ring finger tip | |
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Differential diagnosis | infective endocarditis |
Named after | Sir William Osler |
Osler nodes are tender pinky-purple small bumps found typically on the tips of fingers and toes in infective endocarditis.[1] The centre may appear pale and they may measure around 1cm.[1] They may appear on the sides of fingers and palms of hands, last up to a day and heal without leaving a mark.[1] Unlike Janeway lesions, which also occur in endocarditis, Osler nodes are painful with pain typically preceding the appearance of the bumps.[1]
Osler nodes are named for Sir William Osler.[2]
Causes
Osler's nodes result from the deposition of immune complexes.[3] The resulting inflammatory response leads to swelling, redness, and pain that characterize these lesions.
The nodes are commonly indicative of subacute bacterial endocarditis.[4] 10–25% of endocarditis patients will have Osler's nodes.[citation needed] Other signs of endocarditis include Roth's spots and Janeway lesions. The latter, which also occur on the palms and soles, can be differentiated from Osler's nodes because they are non-tender.[1]
Osler nodes can also be seen in
- Systemic lupus erythematosus
- Marantic endocarditis
- Disseminated gonococcal infection
- Distal to infected arterial catheter
Etymology
Osler nodes are named after Sir William Osler who described them in the early twentieth century.[2] He described them as "ephemeral spots of a painful nodular erythema, chiefly in the skin of the hands and feet."[citation needed]
Additional images
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Osler nodes on index finger
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Osler node on ring finger
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Osler lesions found on the hand and fingers of a 43-year-old male with subacute bacterial endocarditis
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Osler node on ring finger of left hand
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Parashar, Krishan; Daveluy, Steven (2022). "Osler Node and Janeway Lesions". StatPearls. StatPearls Publishing. PMID 32491553. Archived from the original on 2022-05-16. Retrieved 2022-11-04.
- ↑ 2.0 2.1 Yale, Steven H.; Tekiner, Halil; Mazza, Joseph J.; Yale, Eileen S.; Yale, Ryan C. (2021). Cardiovascular Eponymic Signs: Diagnostic Skills Applied During the Physical Examination. Switzerland: Springer. p. 77. ISBN 978-3-030-67595-0. Archived from the original on 2022-10-31. Retrieved 2022-11-04.
- ↑ Farrior, JB; Silverman, ME (August 1976). "A consideration of the differences between a Janeway's lesion and an Osler's node in infectious endocarditis" (PDF). Chest. 70 (2): 239–43. doi:10.1378/chest.70.2.239. PMID 947688. Archived from the original (PDF) on 2014-05-14. Retrieved 2013-08-10.
- ↑ "Osler nodes" at Dorland's Medical Dictionary
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- Symptoms and signs: Cardiac
- William Osler