Case 323

Female patient, 61 years old, with pain and limitation of movement in the distal interphalangeal joints of the hands, with gradual progression in 4 years. Pain worsens with movement and improves with resting. Concomitantly, nodules arose on hand's fingers, most prominent on the 2nd finger, bilaterally. Previous pain with similar characteristics in the left knee. Systemic symptoms, comorbidities and joint trauma are denied. Family history of nodulations in hands similarly to the patient's case and sister undergoing arthroplasty.

Question:
(Direct Access – UFSM 2015) Loss of joint cartilage associated with a reaction in the subchondral bone, with its thickening and osteophyte formation, are physiopathological events related to: