Osler node

Not to be confused with Janeway lesion.
For other Osler's signs, see Osler's sign (disambiguation).
Osler node
Osler node on ring finger tip
Differential diagnosisinfective endocarditis

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. 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

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."

Additional images

  • Osler nodes on index finger
    Osler nodes on index finger
  • Osler node on ring finger
    Osler node on ring finger
  • Osler lesions found on the hand and fingers of a 43-year-old male with subacute bacterial endocarditis
    Osler lesions found on the hand and fingers of a 43-year-old male with subacute bacterial endocarditis
  • Osler node on ring finger of left hand
    Osler node on ring finger of left hand

References

  1. 1 2 3 4 5 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. 1 2 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.
  3. ↑ 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.
  4. ↑ "Osler nodes" at Dorland's Medical Dictionary
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