Which physical exam finding is associated with Osler nodes?

Osler nodes are characterized by small, tender lesions that typically appear on the fat pads of the fingers and toes. They are associated with infective endocarditis and arise due to embolic phenomena leading to localized vasculitis. The tenderness of these lesions distinguishes Osler nodes from other types of lesions that may occur in similar contexts, such as Janeway lesions, which are typically painless.

The presence of these tender lesions indicates a significant infectious process, often linked to the presence of bacteria on heart valves, which can lead to systemic embolization. Recognizing Osler nodes during a physical exam is crucial for clinicians, as their identification can prompt further investigation for potential underlying cardiac conditions or systemic infections.

Other findings, such as painless lesions, are typically associated with Janeway lesions, and white spots on the retina are linked to Roth spots, which represent a different pathological process. A pulsatile mass in the abdomen is unrelated and typically pertains to conditions involving vascular diseases, such as an abdominal aortic aneurysm. Hence, the significance of Osler nodes lies in their specific presentation which speaks to a particular underlying pathology.