The aim of the study was to evaluate the prevalence and pattern of radiographic hand osteoarthritis (OA) in Turkmen community-based sample and its association with age, sex, and BMI. The study population was comprised of Turkmens (277 males and 427 females, age 19-90 years). OA was evaluated for 14 joints of each hand according to the Kellgren and Lawrence grading scheme. Statistical analyses included prevalence estimation, linear and polynomial regressions, and chi2 tests. About 13.8% of individuals before age 36 had at least one joint with OA, and the prevalence reached 100% after age 65. For males and females the best-fitted and most parsimonious model of association between age and number of affected hand joints was a two interval linear one. After adjustment for age, we found that females with severe obesity have higher risk of development of hand OA than those with normal weight [OR(95%CI): 3.88 (1.20-12.60)].