The bony swelling of the proximal interphalangeal finger joint seen in osteoarthritis is called?

UPUMS Nsg officer-2023

Medical Surgical Nursing

Easy

Appeared in: UPUMS Nsg officer-2023

Explanation

Bouchard nodes are characteristic bony enlargements (osteophytes) that occur at the proximal interphalangeal (PIP) joints of the fingers.
These nodes are a hallmark sign of osteoarthritis (OA), a degenerative joint disease.
Their location at the PIP (middle) joint is the key feature that distinguishes them from Heberden nodes.

Option A: Heberden nodes are also bony swellings seen in osteoarthritis, but they are located at the distal interphalangeal (DIP) joints, which are the joints closest to the fingertip.
Option B: Osler's nodes are not bony swellings. They are painful, red, raised lesions found on the pads of the fingers and toes.
Option C: Virchow's node is not a finger joint swelling. It refers to an enlarged, hard lymph node in the left supraclavicular fossa (the hollow above the collarbone).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of osteoarthritis in finger joints as background academic context rather than a clinical decision trigger.
Recognizing the location of these nodes is crucial for accurately assessing and documenting the progression of osteoarthritis.
The presence of Bouchard and Heberden nodes can significantly impact a patient's fine motor skills and ability to perform activities of daily living (ADLs), such as buttoning a shirt or holding utensils. Nursing care should include assessing functional limitations and providing adaptive strategies.
What if? If a patient with a history of osteoarthritis presents with a new, painful, reddish nodule on the pad of their finger instead of a hard, bony swelling on the joint, the nurse should suspect Osler's node and escalate care, as this could indicate a serious systemic infection like infective endocarditis, requiring urgent medical evaluation.

How to Approach the Question

First, identify the key terms in the question: 'bony swelling', 'proximal interphalangeal (PIP) finger joint', and 'osteoarthritis'.
The question is asking for the specific name of a clinical sign.
Recall the two types of nodes associated with osteoarthritis of the hand: Heberden's and Bouchard's nodes.
Differentiate between them based on their anatomical location. Remember 'B' for Bouchard comes before 'H' for Heberden in the alphabet, just as the PIP joint comes before the DIP joint when moving from the body towards the fingertip.
Evaluate the other options. Osler's and Virchow's nodes are associated with completely different and more acute conditions (infective endocarditis and cancer, respectively), so they can be eliminated.
Select the option that correctly matches the sign with the PIP joint location.

Concept Tested & Keywords

Concept Tested: Clinical signs of osteoarthritis in finger joints
Stem keywords: bony swelling, proximal interphalangeal finger joint, osteoarthritis
Lead-in keywords: is called
Negative lead-in flag: false

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E6 Medicine Davidson Principles Practice 24e p. 1029-1031

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1197-1199