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Hand & Upper Limb
intermediate
X-Type

Interphalangeal Arthritis - DIP and PIP Joint Disease

Degenerative Hand Conditions

A 62-year-old right-hand-dominant woman presents with progressive pain and stiffness affecting multiple fingers over the past 5 years. She reports difficulty with fine motor tasks and is concerned about the appearance of her hands. Examination reveals bony nodules at the DIP joints of the index and middle fingers (Heberden nodes) and the PIP joint of the ring finger (Bouchard node). There is a 1cm fluctuant swelling over the dorsal DIP joint of the index finger. Radiographs show joint space narrowing, osteophytes, and subchondral sclerosis at the involved joints. Regarding interphalangeal joint osteoarthritis:

Mark each as TRUE or FALSE

A

Primary osteoarthritis of the hand most commonly affects the DIP joints (Heberden nodes), PIP joints...

B

The fluctuant dorsal swelling at the DIP joint is a mucous cyst (digital myxoid cyst), which is a ga...

C

Heberden and Bouchard nodes primarily affect the MCP joints; inflammatory markers are typically elev...

D

Erosive osteoarthritis (inflammatory OA) is a more aggressive variant affecting PIP and DIP joints c...

E

Differential diagnosis includes rheumatoid arthritis (symmetric MCP/PIP involvement, spares DIP), ps...

Answer the questions to see explanations

Click T (True) or F (False) for each option