Osler's node
Encyclopedia
Osler's nodes are painful, red, raised lesions found on the hands and feet. They are associated with a number of conditions, including infective endocarditis
, and are caused by immune complex
deposition. They are named after Sir William Osler
who described them in the early 20th century. Their presence is one definition of Osler's sign
.
es. The resulting inflammatory response
leads to swelling, redness, and pain that characterize these lesions.
The nodes are commonly indicative of subacute bacterial endocarditis. 10–25% of endocarditis patients will have Osler's nodes. Other signs of endocarditis include Roth's spot
s and Janeway lesion
s. The latter, which also occur on the palms and soles, can be differentiated from Osler's nodes because they are nontender.
It can also be seen in
Infective endocarditis
Infective endocarditis is a form of endocarditis, or inflammation, of the inner tissue of the heart, such as its valves, caused by infectious agents. The agents are usually bacterial, but other organisms can also be responsible....
, and are caused by immune complex
Immune complex
An immune complex is formed from the integral binding of an antibody to a soluble antigen. The bound antigen acting as a specific epitope, bound to an antibody is referred to as a singular immune complex....
deposition. They are named after Sir William Osler
William Osler
Sir William Osler, 1st Baronet was a physician. He was one of the "Big Four" founding professors at Johns Hopkins Hospital as the first Professor of Medicine and founder of the Medical Service there. Sir William Osler, 1st Baronet (July 12, 1849 – December 29, 1919) was a physician. He was...
who described them in the early 20th century. Their presence is one definition of Osler's sign
Osler's sign
The Osler's sign of pseudohypertension is an artificially and falsely elevated blood pressure reading obtained through sphygmomanometry due to arteriosclerotic, calcified blood vessels which do not physiologically compress with pressure....
.
Causes
Osler's nodes result from the deposition of immune complexImmune complex
An immune complex is formed from the integral binding of an antibody to a soluble antigen. The bound antigen acting as a specific epitope, bound to an antibody is referred to as a singular immune complex....
es. The resulting inflammatory response
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
leads to swelling, redness, and pain that characterize these lesions.
The nodes are commonly indicative of subacute bacterial endocarditis. 10–25% of endocarditis patients will have Osler's nodes. Other signs of endocarditis include Roth's spot
Roth's spot
Roth's spots are retinal hemorrhages with white or pale centers composed of coagulated fibrin. They are typically observed via fundoscopy or slit lamp exam....
s and Janeway lesion
Janeway lesion
Janeway lesions are non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter that are pathognomonic of infective endocarditis. Pathologically, the lesion is described to be a microabscess of the dermis with marked necrosis...
s. The latter, which also occur on the palms and soles, can be differentiated from Osler's nodes because they are nontender.
It can also be seen in
- systemic lupus erythematosusLupus erythematosusLupus erythematosus is a category for a collection of diseases with similar underlying problems with immunity . Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs...
- marantic endocarditisMarantic endocarditisMarantic endocarditis, also known as non-bacterial thrombotic endocarditis , is the deposition of small sterile vegetations on valve leaflets....
- disseminated gonococcal infection
- distal to infected arterial catheterCatheterIn medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...