Patient presents with complaints consistent with hand osteoarthritis (OA), including hand pain, stiffness, and reduced range of motion.  Symptoms impact activities of daily living (ADLs) such as gripping, pinching, and fine motor tasks.  Onset of symptoms was gradual (insidious onset) over [timeframe], and the patient reports [aggravating factors, e.g., cold weather, repetitive movements] exacerbate pain while [alleviating factors, e.g., rest, heat] provide some relief.  Physical examination reveals [specific joint involvement, e.g., distal interphalangeal (DIP) joints, proximal interphalangeal (PIP) joints, carpometacarpal (CMC) joint of the thumb], with palpable bony enlargements (Heberden's nodes, Bouchard's nodes) and crepitus on movement.  Radiographic imaging of the hand demonstrates characteristic findings of osteoarthritis, including joint space narrowing, osteophytes, and subchondral sclerosis.  Diagnosis of primary osteoarthritis of the hand is confirmed based on clinical presentation, physical examination findings, and radiographic evidence.  Differential diagnoses considered include rheumatoid arthritis, psoriatic arthritis, and gout.  Treatment plan includes conservative management with non-pharmacological interventions such as occupational therapy for hand exercises and splinting, as well as pharmacological management with analgesics (e.g., acetaminophen, NSAIDs) for pain relief.  Patient education provided on joint protection strategies and activity modification.  Follow-up scheduled to monitor symptom progression and treatment efficacy.  ICD-10 code M15.  Medical billing codes will be applied based on services provided.