Factors other than age and genetics may play a role in explaining the onset of osteoarthritis of the hand. Genetic, physiologic, and anatomic differences in men and women cause the variable expressions of osteoarthritis. These different factors affect women's ability to modify osteoarthritis of the hand before and after its onset, although it is genetic. By maintaining normal weight, good health, and nutrition, one can diminish the genetic and multifactorial effects of osteoarthritis of the hand. Future research in genetics, polymorphism, anatomy, hormonal influences, association with other disease processes, and multifactorial issues will clarify these relationships. Additional studies are needed to investigate the outcomes of gender-specific treatments, joint replacement surgery, and other interventions for osteoarthritis of the hand.