(See also Overview and Evaluation of Hand Disorders Overview and Evaluation of Hand Disorders Common hand disorders include a variety of deformities, ganglia, infections, Kienböck disease, nerve compression syndromes, noninfectious tenosynovitis, and osteoarthritis. (See also complex... read more 
.)
Osteoarthritis affecting the hand may include asymptomatic enlargement of nodules at the proximal interphalangeal joint (Bouchard nodes) or distal interphalangeal joint (Heberden nodes) or angulation at these joints. Pain and stiffness of these joints and the base of the thumb are also common. The wrist usually is spared (unless there was preexisting trauma), and there is usually minimal or no metacarpophalangeal joint involvement unless the patient also has a metabolic disorder (eg, hemochromatosis Hereditary Hemochromatosis Hereditary hemochromatosis is a genetic disorder characterized by excessive iron (Fe) accumulation that results in tissue damage. Manifestations can include systemic symptoms, liver disorders... read more 
).
Differentiation of hand changes in osteoarthritis from those in rheumatoid arthritis is discussed in Evaluation of the Patient With Joint Symptoms Evaluation of the Patient With Joint Symptoms Some musculoskeletal disorders affect primarily the joints, causing arthritis. Others affect primarily the bones (eg, fractures, Paget disease of bone, tumors), muscles or other extra-articular... read more . Gout Gout Gout is a disorder caused by hyperuricemia (serum urate > 6.8 mg/dL [> 0.4 mmol/L]) that results in the precipitation of monosodium urate crystals in and around joints, most often causing... read more 
can cause acutely inflamed Heberden nodes, most frequently described in post menopausal women receiving diuretic therapy.
This photo shows Heberden nodes, hard-tissue (bony) prominences of distal interphalangeal joints seen in patients with osteoarthritis.
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
Heberden nodes are hard-tissue (bony) prominences of distal interphalangeal joints, seen best in this image on the 2nd and 3rd digits of both hands.
By permission of the publisher. From Myers S: Atlas of Rheumatology. Edited by G Hunder. Philadelphia, Current Medicine, 2005.
Bouchard nodes are hard-tissue (bony) prominences of proximal interphalangeal joints, which in this photo are seen best on the digits of the right hand and the 1st and 2nd digits of the left hand.
© Springer Science+Business Media
Treatment of Osteoarthritis of the Hand
Conservative measures
Occasionally corticosteroid injection or surgery
Treatment of osteoarthritis of the hand is symptomatic with analgesics, appropriate rest, splinting, and occasionally corticosteroid injection as needed.
Surgical procedures can help relieve pain and correct deformity for severe changes at the base of the thumb and, less commonly, for advanced degeneration of the interphalangeal joints.
