Hand Case 2 History/Physical Exam

The classic history is joint pain exacerbated by activity and relieved with rest. There is stiffness upon awakening and after periods of inactivity. Constitutional symptoms, such as fever, are absent.

Physical exam may reveal bony prominence at the joint margins and crepitance upon joint manipulation, with little if any joint effusion. Classic findings include osteophytes that manifest as nodes at the PIP (Bouchard's nodes) or DIP (Heberden's nodes) joints.