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The objectives of the present study are to assess the magnitude and the determinants of aesthetic discomfort in hand osteoarthritis (HOA)1 ,2 in 203 consecutive outpatients attending a tertiary care centre (University Hospital) specialised in bone and cartilage metabolism and diagnosed with HOA.3 All distal and proximal interphalangeal joints and thumb base were assessed for painful and tender joints and presence of nodes. A total of 90.1% of the subjects were women. Patient's global assessment of pain used a 100 mm (0–100) Visual Analog Scale (VAS). The patients rated their aesthetic discomfort related to HOA on a 100 mm VAS (0–100) and on a Likert scale (0–7) used for the assessment of aesthetic damage in Forensic (ie, medicolegal assessment) medicine (ranging from 0=no damage to 7=very important damage). Pain, …