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Conditions of the Hand Quiz
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Which location defines Heberden nodes in hand osteoarthritis?
- A Swelling of the metacarpophalangeal joints You picked ✕
- B Bony swelling at the distal interphalangeal joints You picked ✓
- C Inflammation of the wrist joint You picked ✕
- D Bony swelling at the proximal interphalangeal joints You picked ✕
- E Diffuse swelling of the entire finger You picked ✕
Correct!
Incorrect
The answer is B: Bony swelling at the distal interphalangeal joints
Explanation
Why B is correct
See Osteoarthritis of finger joints. Option B is correct. Heberden nodes are hard, bony lumps at the distal interphalangeal joints, the joints nearest the fingertips. They are a classic sign of osteoarthritis of the hands. In osteoarthritis, the cartilage covering the ends of the bones breaks down, and the bone responds by growing small bony spurs called osteophytes. At the fingertip joints these spurs and the surrounding thickening make a visible, hard nodule that is typically painless or mildly uncomfortable. Heberden nodes are used as a clinical marker for osteoarthritis, and they correlate with osteophytes at the same joint on X-ray. Memory aid: Heberden nodes sit at the fingertip end (distal), and Bouchard nodes are one joint closer to the palm (proximal).
- Site: The distal interphalangeal joints, the joints nearest the fingertips.
- Meaning: A classic sign of osteoarthritis of the hands, caused by bony spurs (osteophytes) at the joint.
- Feel: Hard bony lumps that are typically painless or mildly uncomfortable.
- Contrast: Bouchard nodes sit one joint closer to the palm, at the proximal interphalangeal joints.
- Site: The distal interphalangeal joints, the joints nearest the fingertips.
- Meaning: A classic sign of osteoarthritis of the hands, caused by bony spurs (osteophytes) at the joint.
- Feel: Hard bony lumps that are typically painless or mildly uncomfortable.
- Contrast: Bouchard nodes sit one joint closer to the palm, at the proximal interphalangeal joints.
- Site: The distal interphalangeal joints, the joints nearest the fingertips.
- Meaning: A classic sign of osteoarthritis of the hands, caused by bony spurs (osteophytes) at the joint.
- Feel: Hard bony lumps that are typically painless or mildly uncomfortable.
- Contrast: Bouchard nodes sit one joint closer to the palm, at the proximal interphalangeal joints.
Why the other options are incorrect
- A. Swelling of the metacarpophalangeal joints: Swelling of the knuckle joints (metacarpophalangeal joints) is more typical of rheumatoid arthritis. Heberden nodes are hard bony growths of osteoarthritis at the fingertip joints, not soft swellings at the knuckles. Your answer
- C. Inflammation of the wrist joint: Wrist inflammation is not a feature of Heberden nodes. These nodes are bony lumps at the fingertip joints, not a swelling of the wrist. Your answer
- D. Bony swelling at the proximal interphalangeal joints: Bony swellings at the proximal interphalangeal joints, the middle joints of the fingers, are Bouchard nodes. They are also associated with osteoarthritis, but they are a different sign. Your answer
- E. Diffuse swelling of the entire finger: Swelling of the whole finger, giving a sausage-like appearance, is dactylitis, which is characteristic of psoriatic arthritis. It is not a bony nodule at a single joint. Your answer
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1
Which pattern describes a swan-neck deformity in rheumatoid arthritis?
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2
A 58-year-old man with longstanding hyperuricaemia has firm hand nodules that have enlarged slowly over several years and are painless. Which statement best describes these lesions?
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