| Osler's node | |
|---|---|
 | |
| Osler's lesions found on the hand and fingers of a 43-year-old male with subacute bacterial endocarditis | |
| Differential diagnosis | infective endocarditis |
Osler's nodes are painful, red, raised lesions found typically on the hands and feet. [1] They are associated with a number of conditions, including infective endocarditis, and are caused by immune complex deposition. Their presence is one definition of Osler's sign. [2]
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. [5] 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. [3]
Osler's nodes can also be seen in
Osler's nodes are named after Sir William Osler who described them in the early twentieth century. [6] [7] He described them as "ephemeral spots of a painful nodular erythema, chiefly in the skin of the hands and feet." [1]