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J Am Board Fam Med. 2011 Mar-Apr;24(2):169-74. doi: 10.3122/jabfm.2011.02.100156.

Knuckle cracking and hand osteoarthritis.

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  • 1Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.



Previous studies have not shown a correlation between knuckle cracking (KC) and hand osteoarthritis (OA). However, one study showed an inverse correlation between KC and metacarpophalangeal joint OA.


We conducted a retrospective case-control study among persons aged 50 to 89 years who received a radiograph of the right hand during the last 5 years. Patients had radiographically proven hand OA, and controls did not. Participants indicated frequency, duration, and details of their KC behavior and known risk factors for hand OA.


The prevalence of KC among 215 respondents (135 patients, 80 controls) was 20%. When examined in aggregate, the prevalence of OA in any joint was similar among those who crack knuckles (18.1%) and those who do not (21.5%; P = .548). When examined by joint type, KC was not a risk for OA in that joint. Total past duration (in years) and volume (daily frequency × years) of KC of each joint type also was not significantly correlated with OA at the respective joint.


A history of habitual KC-including the total duration and total cumulative exposure-does not seem to be a risk factor for hand OA.

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