Involvement of the distal and proximal interphalangeal joints with the first carpometacarpal joint, with sparing of the wrist and metacarpal joints is seen. The most likely cause is (AIPG 2010)
Osteoarthritis - Knee and hip joints are commonly involved.
1. Trapezio-metacarpal joint of the thumb and the distal interphalangeal joints of the fingers are also affected with sparing of the wrist and metacarpal joints.
Rheumatoid arthritis - sparing of the distal interphalangeal joints is common
Psoriatic arthritis - clinical presentation is same as rheumatoid arthritis with involvement of distal interphalangeal joints.