A 19-year-old man presented with a 3-year history of bilateral, painless, fusiform swelling of the medial and lateral aspects of all fingers. The swelling did not affect finger movement. The patient had no history of significant trauma, pain, or arthritic symptoms and no family history of similar findings. Physical examination revealed firm thickening of the lateral aspects of the second through fifth proximal interphalangeal joints of both hands (Figure 1 and Figure 2). The thumbs, palms, and soles were spared. No joint hyperlaxity was present.