Q. A 60-year-old woman visits the primary care clinic, complaining of hand pain and stiffness that she has been experiencing for the past few years. She reports that the stiffness is particularly pronounced in the evening after periods of activity and that it lasts only a few minutes in the early morning. She is known hypertensive on regular treatment. Her vital signs are normal. During the examination, bony enlargements at the distal interphalangeal (DIP) joints of her fingers are noted. Upon inquiry, she mentions that these nodules have been growing slowly over several years and used to be tender but are not anymore. Based on this presentation, what are these nodules most likely indicative of?