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Hand osteoarthritis — SCE Rheumatology MCQ

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HardOsteoarthritis and Soft Tissue RheumatologyHand osteoarthritisSCE Rheumatology

A 66-year-old man has DIP and first CMC pain, Heberden nodes, thumb-base squaring and morning stiffness lasting 10 minutes. What is the most likely diagnosis?

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Correct answer: AHand osteoarthritis

Hand osteoarthritis is the single best answer because DIP and first CMC involvement with brief stiffness suggests hand osteoarthritis. The stem is testing diagnostic synthesis, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Rheumatoid arthritis is less suitable because it fits a different clinical pattern or a different treatment threshold; Systemic lupus erythematosus, Psoriatic arthritis and Gout do not address the key discriminator in this vignette. Clinical pearl: in SCE-style rheumatology questions, autoantibodies, imaging and synovial fluid findings should be interpreted with the whole phenotype.

Reference: NICE NG226; NICE CKS soft tissue rheumatology