The American College of Rheumatology (ACR) classification criteria were used to define the prevalence of clinical hand osteoarthritis (OA) in an elderly population in Iceland. The prevalence of hand OA was 3.3% for men and 6.8% for women, however, 19.6% of the men and 32.0% of the women fulfilled the ACR examination but lacked required symptoms. The prevalence of clinical signs of OA in the interphalangeal joints were similar for both sexes but were much more common in the first carpometacarpal joint of women (31.3% vs. 1.0% in men, p