The distal interphalangeal joints of the fingers of middle-aged and elderly women are commonly nodular and enlarged, sometimes with mild pressure pain and pain on movement, but to a lesser degree. There is also sometimes numbness, tingling, and stiffness in the fingertips. In some patients, the joint may be slightly flexed or displaced. It often affects one or several fingers and is often insidious. It is called heberden’s node. It is a characteristic sign of osteoarthritis of the hand. It is usually seen in women and has a genetic predisposition. It is often seen in sisters or mothers and daughters at the same time. x-ray of the phalangeal joint shows hypertrophy of the bony ends of the fingers and hyperplasia of the bones. A similar bony nodule in the proximal interphalangeal joint is called Bouchard’s nodule.