Osler's nodes are painful,
red, raised
lesion
A lesion is any damage or abnormal change in the tissue of an organism, usually caused by injury or diseases. The term ''Lesion'' is derived from the Latin meaning "injury". Lesions may occur in both plants and animals.
Types
There is no de ...
s found typically on the hands and feet.
They are associated with a number of conditions, including
infective endocarditis
Infective endocarditis is an infection of the inner surface of the heart (endocardium), usually the heart valve, valves. Signs and symptoms may include fever, petechia, small areas of bleeding into the skin, heart murmur, feeling tired, and anem ...
, and are caused by
immune complex
An immune complex, sometimes called an antigen-antibody complex or antigen-bound antibody, is a molecule formed from the binding of multiple antigens to antibodies. The bound antigen and antibody act as a unitary object, effectively an antigen of ...
deposition. Their presence is one definition of Osler's sign.
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Causes
Osler's nodes result from the deposition of
immune complex
An immune complex, sometimes called an antigen-antibody complex or antigen-bound antibody, is a molecule formed from the binding of multiple antigens to antibodies. The bound antigen and antibody act as a unitary object, effectively an antigen of ...
es.
The resulting
inflammatory response
Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...
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 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.
Osler's nodes can also be seen in
*
Systemic lupus erythematosus
Lupus, formally called systemic lupus erythematosus (SLE), is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary among people and may be mild to severe. Common ...
*
Marantic endocarditis
Nonbacterial thrombotic endocarditis (NBTE) is a form of endocarditis in which small sterile vegetations are deposited on the valve leaflets. Formerly known as marantic endocarditis, which comes from the Greek , meaning "wasting away". The term ...
* Disseminated
gonococcal infection
* Distal to infected arterial
catheter
In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...
Etymology
Osler's nodes are named after Sir
William Osler
Sir William Osler, 1st Baronet, (; July 12, 1849 – December 29, 1919) was a Canadian physician and one of the "Big Four" founding professors of Johns Hopkins Hospital. Osler created the first Residency (medicine), residency program for speci ...
who described them in the early twentieth century.
He described them as "ephemeral spots of a painful nodular erythema, chiefly in the skin of the hands and feet."
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References
{{Cardiovascular system symptoms and signs
Symptoms and signs: Cardiac
William Osler