In contrast to the well-established link between Black race and knee or hip osteoarthritis (OA), this study demonstrated a lower risk of hand OA among Black individuals relative to non-Black persons, which was not mediated by recognized hand OA risk factors. There is a need for future studies to unveil the mediating protective factors for hand OA among Black persons.

• Researchers used available hand radiographs from the Osteoarthritis Initiative cohort (total 4,699; n = 849 Black subjects [18.1%], n = 3,850 non-Black subjects [81.9%]) to analyze the links between Black race and the presence of radiographic, symptomatic, and clinical hand OA.

• Relative to non-Black participants, Black ones were found to have less severe hand OA and a lower risk of developing radiographic hand OA (odds ratio:OR 0.79), erosive hand OA (OR 0.23), symptomatic hand OA (OR 0.63), and clinical hand OA (OR 0.49).