Thirty-five patients with OA of the hands had an early and late phase isotope bone scan performed at entry and 1 yr later. Simultaneous assessment of symptoms was made by a visual analogue pain score (VAS) and a tender joint articular index (AI) and comparisons were made between the clinical and scintigraphic findings. Sixty-five percent of joints were classed as positive in the late phase compared to 17% in the early phase scan. Thirteen per cent of joints were positive only in the early phase and 49% only in the late phase. There was no significant overall change in either phase of the scan in 1 yr. The pattern of positive joints showed considerable symmetry and wrist involvement. There was a high degree of correlation between AI and the late phase scan but none with the early phase scan. VAS showed no correlation with the late phase scan but did correlate significantly with the early phase scan at 1 yr.