Distal interphalangeal (DIP) joint involvement is a feature of hand osteoarthritis (OA), psoriatic arthritis (PsA) and Gout. Objectives: to explore the demographic, clinical and radiological features of DIP- joint involvement in Egyptian Patients. Patients and methods: 320 patients with DIP-joint arthropathy were involved from the Rheumatology and Immunology units of three Egyptian University Hospitals. Data on demographics, clinical conditions, and treatments were gathered. Patients were examined for evidence of osteoarthritis, Psoriasis, gout and Rheumatoid Arthritis (RA) and examined using standard hand radiography. Erythrocyte Sedimentation rate (ESR) and C-reactive protein (CRP) were done. Prevalence’s were determined on all included fingers and differences in prevalence’s were tested using Chi-square statistics. Results: DIPJ-OA was diagnosed in 275 cases (85.9%), with erosions in 6 cases (2.2%). The remaining 45 (14.1%) were diagnosed as non-OA-DIPJ (31 psoriasis, 9 gout, and 5 RA), with erosions in 5 cases (11.1%), all of them had a diagnosis of PsA. Compared to non-OA-DIPJ, DIPJ-OA showed statistically significantly higher morning stiffness (MS) 5-15 minutes, duration of symptoms up to 10 years, symptomatic knee OA, and statistically significantly lower erosions, family history of DIPJ involvement, diabetes, osteophytes, ESR, and CRP. Statistically significantly higher erosions, MS, symptom duration > 10 years, positive family history of DIPJ involvement, psoriasis in a 1st degree relative, dactylitis, and joint space narrowing were found in PsA vs. non-PsA. Conclusion: The demographic and Clinical features of Egyptian patients with DIP-Joint involvement are comparable to those from other countries.