College of Massage Therapists of British Columbia (CMTBC) Practice Exam

What arthritic change is indicated by joint enlargement and capsule thickening at the proximal interphalangeal joints?

1. Bouchard's nodes

2. Heberden's nodes

3. Swan neck deformity

4. Boutonniere deformity

The correct answer is: Heberden's nodes

The enlargement of joints and thickening of the joint capsule at the proximal interphalangeal joints is indicative of Bouchard's nodes. These nodes occur in the context of osteoarthritis and present as bony protrusions found on the proximal interphalangeal joints. In osteoarthritis, the degradation of cartilage and subsequent changes in the surrounding structures lead to inflammation and the formation of these nodes. This is a distinguishing feature in the assessment of joint conditions, particularly for differentiating between various types of arthritis. While Heberden's nodes are also symptomatic of osteoarthritis, they occur at the distal interphalangeal joints rather than the proximal interphalangeal joints. Swan neck and Boutonniere deformities are associated with rheumatoid arthritis and describe specific deformities rather than joint enlargement as seen in this question. Understanding these nuances helps in accurately diagnosing and treating the relevant conditions.