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Osteoarthritis — SCE Rheumatology MCQ

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EasyOsteoarthritisOsteoarthritisSCE Rheumatology

A 68-year-old woman has bilateral bony swelling of the distal interphalangeal joints and first carpometacarpal joints. Hand radiographs show joint-space narrowing, osteophytes and subchondral sclerosis. What is the eponymous term for the distal interphalangeal joint swellings?

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Correct answer: EHeberden nodes

Heberden nodes are firm bony swellings arising at the distal interphalangeal joints and are characteristic of nodal hand osteoarthritis. The age, first carpometacarpal involvement and radiographic joint-space narrowing, osteophytes and subchondral sclerosis support osteoarthritis. Bouchard nodes occur at the proximal interphalangeal joints. Tophi are deposits of monosodium urate associated with chronic gout and are not simply osteoarthritic bony enlargement. Rheumatoid nodules usually occur over extensor or pressure surfaces in seropositive rheumatoid arthritis. Garrod pads, or knuckle pads, are fibrous thickenings over the dorsal aspects of interphalangeal joints, most often the proximal interphalangeal joints.

Reference: Gloucestershire Hospitals NHS Foundation Trust. Osteoarthritis in the Hand, section 'Making the diagnosis'. Accessed 19 August 2026. https://www.gloshospitals.nhs.uk/our-services/services-we-offer/trauma-orthopaedics/hand-clinic/hand-conditions/osteoarthritis-in-the-hand/