A patient aged 40-years presents with ahritis of PIP and DIP along with carpometacarpal joint of thumb and sparing of wrist and metacarpophalangeal joint. What is the most likely cause?

Osteoahritis- involves the weight-bearing joints, including the knees, hips, cervical and lumbosacral spine, and feet. Other commonly affected joints- DIP, PIP, and carpometacarpal (CMC) joints. Hebedren nodes, which represent palpable osteophytes in the DIP joints, are more characteristic in women than in men. Bouchard nodes which represent palpable osteophytes in the PIP joints Choice A has exclusive DIP involvement and sausage fingers so is ruled out Choice C has bilateral PIP, MCP and wrist involvement while in this case sparing of wrist is given and is hence ruled out Choice D has exclusive knee joint involvement and hence is ruled out