Bouchard's Nodes Causes and Treatments

Bony Joint Nodules Seen With Hand Osteoarthritis

Bouchard's nodes are a classic sign of osteoarthritis (OA) of the hand. They were named after the French pathologist Charles-Joseph Bouchard, who studied arthritis patients in the 19th century.

Bouchard nodes are bony enlargements of the middle joints of the fingers, also known as proximal interphalangeal (PIP) joints. These are the first joint immediately above the knuckles where you would wear a ring.

Heberden's nodes are similar bony swellings that develop at the distal interphalangeal (DIP) joint closest to the fingertips. Bouchard's nodes are less common than Heberden's nodes.

An elderly woman with arthritic hands.

Camille Tokerud Photography Inc. / Getty Images

Bouchard's Nodes Symptoms

Bouchard's nodes, like Heberden's nodes, may or may not be painful, but will typically affect the range of motion of a joint. Over time, the accumulation of excess bone tissue can cause bones to misalign and become crooked.

When this happens, it can often be difficult to do daily tasks like opening a jar, using a can opener, or even turning a car key.


Osteoarthritis most often affects the joints of the hands, the knees, the hips, the lower back, and the neck. In OA of the hand, the articular cartilage in the joints begins to wear away, removing the tissues that normally cushion the joint space. As this happens, a person starts experiencing pain, stiffness, and even visible enlargement of the joint.

In addition, the cartilage becomes rough, making it difficult for the joint bones to slip past each other. When enough cartilage is worn away, the bones begin rubbing against each other, often causing extreme pain and inflammation.

Joint damage and inflammation can lead to the excessive remodeling of bone tissue, known as ossification. As the ossification continues haphazardly and unchecked, unsightly nodules can develop. Those affecting the PIP joint are called Bouchard's nodes.

Genetics has a probable role in the development of Bouchard's nodes as they are commonly seen in families. Also, women are more likely to be affected than men.

With that being said, the prime trigger for their development is the same as any other form of OA: the long-term wear and tear of joint tissues.


A Bouchard's node is considered a characteristic sign of OA, helping differentiate it from other types of arthritis, such as gout or rheumatoid arthritis (RA). Lab and imaging tests (e.g., X-ray) are done to confirm the diagnosis.

With that being said, there are also bumps commonly associated with RA and gout. Rubbery bumps, called rheumatoid nodules, may be seen on the thumbs and knuckles in people with RA. Likewise, people with frequent gout attacks may develop crystallized lumps in the joint space called tophi.

Simple blood and imaging tests can help distinguish the various types of arthritis.

A complete blood count (CBC) may be used to detect a high white blood cell count (WBC) consistent with inflammation. Because OA is not associated with chronic inflammation, the WBC will usually be lower than gout and RA, both of which are inflammatory.


The treatment for Bouchard's nodes is similar for hand OA without nodes. This includes:

Joint immobilization may also be used during acute flare-ups to minimize joint movement.

Once a node has formed, it is not inherently painful, but will likely exacerbate any pain that occurs with movement. By this stage, physical or occupational therapy may be needed to better ensure joint mobility and prevent disability. Surgery is rarely, if ever, used for cosmetic purposes.

Frequently Asked Questions

  • What are Bouchard's nodes?

    They are bony overgrowths, also called bone spurs, in the joints in the middle of the finger. They're caused by wear and tear of bone rubbing against bone from osteoarthritis in the hand.

  • What's the difference between Heberden's nodes and Bouchard's nodes?

    Heberden's nodes are bony enlargements in the joints closest to your fingernails. Bouchard's nodes are bony enlargements in the middle joints, above where you would wear a ring.

  • Can you get rid of Bouchard's nodes?

    Not completely. You can treat the pain with rest, pain relievers, and heat and ice therapy. The bump itself won't go away unless you have surgery to remove it, but that procedure is rarely performed.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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