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Jan van Eyck
1390, Maaseik – 19 July 1441, Ghent, Belgium
Jan van Eyck was a Flemish painter who perfected the newly developed oil painting technique.
His naturalistic panel paintings, mainly portraits and religious subjects, are replete with hidden religious symbols.
His masterpiece is the altarpiece The Adoration of the Lamb, commissioned for Ghent Cathedral.
According to some, it was Hubert van Eyck, Jan’s brother, who began the painting.
♦ Panel depicting St John the Baptist from *The Adoration of the Lamb* ♦
Saint John the Baptist is holding a large prayer book and, judging by the position of his right hand, he is teaching.
He has long brown hair and a luxuriant beard. Over his shepherd’s clothes, he wears a green liturgical robe richly adorned with pearls and precious stones.
♦ Diagnosis
Key findings: Bony Heberden’s nodule on the thumb
Additional findings: Middle-aged man with a slight valgus deformity of the left big toe.
Clinical diagnosis: Osteoarthritis of the hand
♦ Definition: osteoarthritis of the hand
Osteoarthritis of the hand is an age-related degenerative joint disease that can have several causes.
The condition leads to cartilage loss and a reduction in bone mass.
Heberden’s nodes are also associated with generalised osteoarthritis.
♦ Definition: X-toe or hallux valgus
An X-toe is a lateral deviation of the big toe that occurs as a secondary symptom of osteoarthritis of the foot.
♦ Discussion
The swollen lumps on the DIP joint of the thumb, which we call Herberden’s nodules, are depicted very realistically.
They are similar to the fingers of a modern-day patient with osteoarthritis of the hand.
Osteoarthritis of the hand is usually associated with osteoarthritis of other joints, such as those of the big toe—which results in a valgus deformity—or those of the knee and spine.
For this reason, these nodules are also regarded as indicators of generalised osteoarthritis.
William Heberden Sr. (1710–1801) was an English physician who described these swollen nodules on the small joints of the hand.
♦ Osteoarthritis
of the hand is an indication of a predisposition to generalised osteoarthritis. The condition is common, has a familial component and is often associated with a robust build. The bony nodules are painful when they first appear, usually around the age of 50 (menopause in women), but once they have fully developed and hardened, the pain subsides. Patients mainly complain about their unsightly appearance.
Patients with osteoarthritis of the hand joints are more often overweight or of a sturdier build than others. As they generally have greater bone mass, they are less prone to fractures caused by osteoarthritis.
A bunion (hallux valgus) involving extension of the first joint between the toe and the foot (metatarsophalangeal joint) is the equivalent of Heberden’s nodes on the hand.
It is one of the main indicators of osteoarthritis and is very common in older people.
Bunion toes can cause problems when wearing shoes or walking.
Jan Dequeker
The artist and the doctor look at paintings