a phalanx is named according to whether it is proximal, middle, or distal and its associated finger or toe. the proximal phalanges are those that are closest to the hand or foot. in the hand, the prominent, knobby ends of the phalanges are known as knuckles. the proximal phalanges join with the metacarpals of the hand or metatarsals of the foot at the metacarpophalangeal joint or metatarsophalangeal joint. the intermediate phalanx is not only intermediate in location, but usually also in size. the thumb and large toe do not possess a middle phalanx. the distal phalanges are the bones at the tips of the fingers or toes. the proximal, intermediate, and distal phalanges articulate with one another through interphalangeal articulations.