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Among the following, which condition is suggested by the presence of bony nodules on the distal interphalangeal joints?

  1. Osteoarthritis

  2. Rheumatoid arthritis

  3. Fibromyalgia

  4. Gout

The correct answer is: Osteoarthritis

The presence of bony nodules on the distal interphalangeal joints is characteristic of osteoarthritis. These nodules are known as Heberden's nodes and are the result of bony growth or osteophyte formation at the joint due to the degenerative changes associated with osteoarthritis. This condition leads to wear and tear on the cartilage, resulting in pain, stiffness, and the characteristic bony protrusions. In contrast, rheumatoid arthritis primarily affects the proximal interphalangeal joints and is associated with soft tissue swelling rather than bony nodules. Fibromyalgia is characterized by widespread musculoskeletal pain but does not cause specific changes in the joints, such as bony nodules. Gout typically presents with acute inflammation, pain, and swelling of the joints due to crystal deposition but does not specifically cause bony nodules at the distal interphalangeal joints. Thus, the identification of bony nodules specifically indicates osteoarthritis.