Knuckle Cracking and Hand Osteoarthritis

Background: 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. Methods: 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. Results: 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 x years) of KC of each joint type also was not significantly correlated with OA at the respective joint. Conclusions: A history of habitual KC-including the total duration and total cumulative exposure-does not seem to be a risk factor for hand OA. (J Am Board Fam Med 2011;24:169-174.)