A 62-year-old woman presents with gradual onset of painless bony swellings at the distal interphalangeal joints of both hands over 2 years. Examination reveals hard, fixed nodules at the DIP joints with mild ulnar deviation. The first carpometacarpal joints are tender with crepitus. Which statement correctly describes these findings?

• A The nodules at DIP joints are called Bouchard's nodes and indicate synovial hypertrophy
• B The nodules at DIP joints are called Heberden's nodes and represent osteophyte formation ✓
• C These findings are pathognomonic of rheumatoid arthritis
• D These nodules represent reversible synovitis and will resolve with NSAIDs

Explanation

Heberden's nodes are bony swellings at DIP joints caused by osteophyte formation in osteoarthritis. Bouchard's nodes are similar but occur at PIP joints. The first CMC joint is also commonly affected in hand OA. These are not reversible and are distinct from RA which spares DIP joints and involves MCP and PIP joints instead.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.