According to findings, hand osteoarthritis (OA) represents a heterogeneous condition with complex disparities by age, gender and race, hand symptoms and patterns of specific joints.

• This study included 3588 participants in whom prevalence, incidence, and progression of radiographic and symptomatic hand OA was described, and age, gender, race and risk factors differences were assessed.

• For radiographic and symptomatic hand OA, the prevalence was 41.4% and 12.4 %, respectively.

• Over 48 months, an incidence of 5.6 % for radiographic hand OA, and 16.9 % for symptomatic hand OA, was reported.

• OA progression occurred in 27.3 % participants over 48 months.

• There existed complex disparities by age, gender and race with both males and females exhibiting increasing prevalent hand OA with age, but women peaking at age 55-65, for incident disease.

• More symptomatic hand OA but only non-significantly higher rates for incident radiographic hand OA were present in women vs men.

• More distal interphalangeal joint disease occurred in women while more metacarpal joint OA in men.

• Black men and women were found to have less hand OA compared with whites but black men developed more hand OA compared with black women at younger ages.