Osteoarthritis (OA) of the hand has been suggested to be the result of "wear" and "tear." If so, OA should develop more frequently in the dominant hand. We compared dominant with nondominant hands of 134 consecutive community subjects aged 53-75 by questionnaire, radiographs of hands, and rheumatologic evaluation. Mean age was 60 years, 93% were right handed, and 95% were in occupations classified as nonphysical. Subjects estimated dominant hand use of 2-10 times the amount of the nondominant hand. OA was found in 133 of 134 subjects. No radiologic or clinical differences were found between the dominant and nondominant hands. Twenty-six subjects who self-reported heavier lifetime hand use had somewhat greater clinical and hand radiographic OA scores than the 36 subjects reporting lighter hand use (43.5 vs 34.5) (p less than 0.01). In our study population, OA was not more prevalent in the dominant hand.