The bony swelling of the distal inter-phalangeal finger joint seen in osteoarthritis is called?

UPUMS Nsg officer-2023

Medical Surgical Nursing

Easy

Appeared in: UPUMS Nsg officer-2023

Explanation

Heberden's nodes are bony growths (osteophytes) that develop on the distal interphalangeal (DIP) joints, the joints nearest to the fingertips.
They are a hallmark clinical sign of hand osteoarthritis, resulting from the degeneration of joint cartilage and subsequent bone spur formation.
While they can be painless, they may also cause aching, stiffness, and reduced finger mobility.

Option A: Osler's nodes are painful, red, raised lesions on the pads of fingers and toes. They are an immunological phenomenon.
Option B: Virchow's node (or Troisier's sign) is an enlarged, hard lymph node in the left supraclavicular fossa (the hollow above the collarbone). It is not related to finger joints.
Option C: Bouchard nodes are also bony swellings characteristic of osteoarthritis, but they are located at the proximal interphalangeal (PIP) joints, the middle joints of the fingers.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of Osteoarthritis as background academic context rather than a clinical decision trigger.
Correctly identifying the type and location of joint nodes is a fundamental nursing assessment skill. It helps differentiate between degenerative joint disease (Osteoarthritis), inflammatory arthritis, and systemic conditions like infection (Endocarditis) or malignancy.
Patient education is a key nursing role. When a patient has Heberden's nodes, the nurse can explain that this is a sign of osteoarthritis and provide education on managing symptoms through pain relief, joint protection techniques, and appropriate exercises.
Recognizing 'red flag' signs is critical for patient safety. While Heberden's nodes are chronic, identifying Osler's nodes or a Virchow's node would necessitate urgent referral and investigation for serious underlying diseases.

How to Approach the Question

First, break down the question into key components: the pathology ('bony swelling'), the location ('distal inter-phalangeal finger joint'), and the condition ('osteoarthritis').
The most specific clue is the location: 'distal inter-phalangeal' or DIP joint. This is the joint at the very end of the finger.
Systematically evaluate each option based on this information.
Recall or deduce the characteristics of each named node. Osler's nodes are related to endocarditis and are painful papules. Virchow's node is a lymph node in the neck related to cancer.
This leaves Bouchard and Heberden nodes, both related to osteoarthritis. The key differentiator is location. Recall that Heberden nodes are on the Distal (DIP) joints and Bouchard nodes are on the Proximal (PIP) joints.
Since the question specifies the DIP joint, Heberden nodes is the only correct match.

Concept Tested & Keywords

Concept Tested: Clinical signs of Osteoarthritis
Stem keywords: bony swelling, distal inter-phalangeal finger joint, osteoarthritis
Lead-in keywords: is called

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E6 Medicine Davidson Principles Practice 24e pp. 1029-1031, 548-550