<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 72-year-old man presents to his primary care physician for his annual exam. He has a very stoic personality and says that he is generally very healthy and has the normal aches and pains of old age. On further probing, you learn that he does have pretty significant back and hip pain that worsens throughout the day. On physical exam you note bony enlargement of the distal interphalangeal joints bilaterally. Which of the following is the likely cause of his symptoms?? A: Gout, B: Pseudogout, C: Rheumatoid arthritis, D: Osteoarthritis, E: Osteopaenia,  <response>: This is a clinical vignette describing a 72-year-old man with progressive back and hip pain throughout the day as well as bony enlargements of the DIP joints bilaterally. The question is asking about the most likely diagnosis to explain his symptoms.Based on the patients advanced age, progressive joint pains, and physical exam finding of Heberdens nodes bony DIP joint enlargements, the most likely diagnosis is osteoarthritis. Gout and pseudogout typically affect the 1st MTP joint. Rheumatoid arthritis could cause similar joint findings but is less common in older males and usually spares the DIP joints early on. Osteopaenia would not explain his joint pains.D: Osteoarthritis 