The answer is #1 osteoarthritis. The patient's right hand reveals the typical changes with both Heberden's and Bouchard's nodes and irregular deformities at the joints.
Osteoarthritis is a degenerative syndrome where low-grade inflammation results in pain in the joints. The cause is unknown and there is an abnormal wearing of the cartilage that covers and acts as a cushion inside joints. OA affects nearly 21 million people in the U.S. and it affects the hands, spine and large weight-bearing joints such as hips and knees.