Which joint is preferentially affected in osteoarthritis compared to rheumatoid arthritis?

In osteoarthritis, the distal interphalangeal joints (DIPs) are preferentially affected due to the degenerative nature of the disease. Osteoarthritis typically involves weight-bearing joints and those that undergo repetitive motion, leading to wear and tear, and this prominently includes the DIPs, which can develop bony enlargements known as Heberden's nodes.

In contrast, rheumatoid arthritis is primarily a systemic inflammatory condition that commonly affects the proximal interphalangeal joints and metacarpophalangeal joints, rather than the DIPs. This differentiates the two types of arthritis, as rheumatoid arthritis involves symmetric joint symptomatology and is often associated with morning stiffness and systemic features, whereas osteoarthritis is characterized by joint pain that worsens with activity and may improve with rest.

Understanding the distinct patterns of joint involvement in osteoarthritis versus rheumatoid arthritis is crucial for proper diagnosis and management. The preference for the DIPs in osteoarthritis serves as a clinical clue that aids in differentiating between these two common types of arthritis.