Rheumatology International

, Volume 38, Issue 5, pp 865–870 | Cite as

2D:4D finger length ratio and radiographic hand osteoarthritis

  • L. KalichmanEmail author
  • V. Batsevich
  • E. Kobyliansky
Observational Research


To evaluate the association between the index and ring finger’s (2D:4D) length ratio with the prevalence and severity of radiographic hand osteoarthritis (OA). A population-based sample included 802 males (mean age 46.98 ± 17.10 years) and 738 females (mean age 48.65 ± 16.62 years) who had participated in a Chuvashian skeletal aging study. Age, sex, basic demographics, anthropometric data and X-rays of both hands were acquired. Each hand was visually classified on X-ray as either type 1—index finger longer than the ring finger; type 2—index and ring finger equal in length; or type 3—index finger shorter than the ring finger. Hand OA was defined by the number of affected joints (Kellgren–Lawrence score ≥ 2) in both hands and the sum total of Kellgren–Lawrence scores (total OA score). After comparing the OA variables of individuals with different finger length ratio types (after adjustment for age and BMI) significant differences were found only in females between finger ratio types of the right hand in a number of affected joints (F = 3.153, p = 0.043) and finger ratio types of the left (F = 3.330, p = 0.036) and right (F = 2.397, p = 0.047) hands of the total OA score. Females with type 3 ratios had the highest adjusted values of hand OA parameters. We found that finger length ratios are associated with hand OA parameters. Females with a type 3 finger length pattern showed significantly higher hand OA values than those with types 1 and 2.


2D:4D Finger length ratio Hand Osteoarthritis Chuvash 



The authors thank Mrs Phyllis Curchack Kornspan for her editorial services.

Compliance with ethical standards

Conflicts of interest

The author(s) declare that they have no conflicts of interest.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


  1. 1.
    Lutchmaya S, Baron-Cohen S, Raggatt P, Knickmeyer R, Manning JT (2004) 2nd to 4th digit ratios, fetal testosterone and estradiol. Early Hum Dev 77(1–2):23–28. doi: 10.1016/j.earlhumdev.2003.12.002 CrossRefPubMedGoogle Scholar
  2. 2.
    McIntyre MH (2006) The use of digit ratios as markers for perinatal androgen action. Reprod Biol Endocrinol 4:10. doi: 10.1186/1477-7827-4-10 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Putz D, Gaulin S, Sporter R, McBurney D (2004) Sex hormones and finger length: What does 2D: 4D indicate? Evol Hum Behav 25:182–199CrossRefGoogle Scholar
  4. 4.
    Manning JT, Taylor RP (2001) Second to fourth digit ratio and male ability in sport: implications for sexual selection in humans. Evol Hum Behav 22:61–69CrossRefPubMedGoogle Scholar
  5. 5.
    Paul SN, Kato BS, Hunkin JL, Vivekanandan S, Spector TD (2006) The big finger: the second to fourth digit ratio is a predictor of sporting ability in women. Br J Sports Med 40(12):981–983. doi: 10.1136/bjsm.2006.027193 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Manning JT, Bundred PE (2000) The ratio of 2nd to 4th digit length: a new predictor of disease predisposition? Med Hypotheses 54(5):855–857. doi: 10.1054/mehy.1999.1150 CrossRefPubMedGoogle Scholar
  7. 7.
    Vehmas T, Solovieva S, Leino-Arjas P (2006) Radiographic 2D: 4D index in females: no relation to anthropometric, behavioural, nutritional, health-related, occupational or fertility variables. J Negat Results Biomed 5:12. doi: 10.1186/1477-5751-5-12 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Arazi H, Eghbali E, Saeedi T, Moghadam R (2016) The relationship of physical activity and anthropometric and physiological characteristics to bone mineral density in postmenopausal women. J Clin Densitom 19(3):382–388. doi: 10.1016/j.jocd.2016.01.005 CrossRefPubMedGoogle Scholar
  9. 9.
    Hussain SM, Wang Y, Muller DC, Wluka AE, Giles GG, Manning JT, Graves S, Cicuttini FM (2014) Association between index-to-ring finger length ratio and risk of severe knee and hip osteoarthritis requiring total joint replacement. Rheumatology (Oxford) 53(7):1200–1207. doi: 10.1093/rheumatology/keu021 CrossRefGoogle Scholar
  10. 10.
    de Kruijf M, Kerkhof HJ, Peters MJ, Bierma-Zeinstra S, Hofman A, Uitterlinden AG, Huggen FJ, van Meurs JB (2014) Finger length pattern as a biomarker for osteoarthritis and chronic joint pain: a population-based study and meta-analysis after systematic review. Arthritis Care Res (Hoboken) 66(9):1337–1343. doi: 10.1002/acr.22320 CrossRefGoogle Scholar
  11. 11.
    Sigurjonsdottir K, Bjorgulfsson TM, Aspelund T, Eiriksdottir G, Sigurdsson S, Ingvarsson T, Harris TB, Launer L, Gudnason V, Jonsson H (2013) Type 3 finger length pattern is associated with total knee replacements due to osteoarthritis but not with hip replacements or hand osteoarthritis in the elderly: the AGES-Reykjavik study. BMC Musculoskelet Disord 14:112. doi: 10.1186/1471-2474-14-112 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Ferraro B, Wilder FV, Leaverton PE (2010) Site specific osteoarthritis and the index to ring finger length ratio. Osteoarthr Cartil 18(3):354–357. doi: 10.1016/j.joca.2009.11.001 CrossRefPubMedGoogle Scholar
  13. 13.
    Zhang W, Robertson J, Doherty S, Liu JJ, Maciewicz RA, Muir KR, Doherty M (2008) Index to ring finger length ratio and the risk of osteoarthritis. Arthritis Rheum 58(1):137–144. doi: 10.1002/art.23237 CrossRefPubMedGoogle Scholar
  14. 14.
    Kalichman L, Malkin I, Livshits G, Kobyliansky E (2006) The association between morbidity and radiographic hand osteoarthritis: a population-based study. Jt Bone Spine 73(4):406–410. doi: 10.1016/j.jbspin.2005.11.013 CrossRefGoogle Scholar
  15. 15.
    Kalichman L, Cohen Z, Kobyliansky E, Livshits G (2002) Interrelationship between bone aging traits and basic anthropometric characteristics. Am J Hum Biol 14(3):380–390. doi: 10.1002/ajhb.10051 CrossRefPubMedGoogle Scholar
  16. 16.
    Kalichman L, Livshits G, Kobyliansky E (2006) Indices of body composition and chronic morbidity: a cross-sectional study of a rural population in central Russia. Am J Hum Biol 18(3):350–358. doi: 10.1002/ajhb.20506 CrossRefPubMedGoogle Scholar
  17. 17.
    Kobyliansky E, Livshits G, Pavlovsky O (1995) Population biology of human aging: methods of assessment and sex variation. Hum Biol 67(1):87–109PubMedGoogle Scholar
  18. 18.
    Pavlovsky O, Kobyliansky E (1997) Population biology of human aging angelo pontecorboli editore. Firenze, ItalyGoogle Scholar
  19. 19.
    Robertson J, Zhang W, Liu JJ, Muir KR, Maciewicz RA, Doherty M (2008) Radiographic assessment of the index to ring finger ratio (2D: 4D) in adults. J Anat 212(1):42–48. doi: 10.1111/j.1469-7580.2007.00830.x PubMedPubMedCentralGoogle Scholar
  20. 20.
    Kalichman L, Zorina D, Batsevich V, Kobyliansky E (2013) 2D: 4D finger length ratio in the Chuvashian population. Homo 64(3):233–240. doi: 10.1016/j.jchb.2013.02.051 CrossRefPubMedGoogle Scholar
  21. 21.
    Kellgren J, Lawrence J (1963) Atlas of standard radiographs: the epidemiology of chronic rheumatism, vol 2. Blackwell Scientific Publications, OxfordGoogle Scholar
  22. 22.
    Cauley JA, Kwoh CK, Egeland G, Nevitt MC, Cooperstein L, Rohay J, Towers A, Gutai JP (1993) Serum sex hormones and severity of osteoarthritis of the hand. J Rheumatol 20(7):1170–1175PubMedGoogle Scholar
  23. 23.
    Demissie S, Cupples LA, Myers R, Aliabadi P, Levy D, Felson DT (2002) Genome scan for quantity of hand osteoarthritis: the Framingham Study. Arthritis Rheum 46(4):946–952. doi: 10.1002/art.10149 CrossRefPubMedGoogle Scholar
  24. 24.
    Dominick KL, Jordan JM, Renner JB, Kraus VB (2005) Relationship of radiographic and clinical variables to pinch and grip strength among individuals with osteoarthritis. Arthritis Rheum 52(5):1424–1430. doi: 10.1002/art.21035 CrossRefPubMedGoogle Scholar
  25. 25.
    Haugen IK, Niu J, Aliabadi P, Felson DT, Englund M (2011) The associations between finger length pattern, osteoarthritis, and knee injury: data from the Framingham community cohort. Arthritis Rheum 63(8):2284–2288. doi: 10.1002/art.30408 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Kalichman L, Kobyliansky E, Livshits G (2006) Characteristics of joint degeneration in hand osteoarthritis. Jt Bone Spine 73(1):72–76. doi: 10.1016/j.jbspin.2004.05.018 CrossRefGoogle Scholar
  27. 27.
    Linn S, Murtaugh B, Casey E (2012) Role of sex hormones in the development of osteoarthritis. PM & R 4(5 Suppl):S169–S173. doi: 10.1016/j.pmrj.2012.01.013 CrossRefGoogle Scholar
  28. 28.
    Tanamas SK, Wijethilake P, Wluka AE, Davies-Tuck ML, Urquhart DM, Wang Y, Cicuttini FM (2011) Sex hormones and structural changes in osteoarthritis: a systematic review. Maturitas 69(2):141–156. doi: 10.1016/j.maturitas.2011.03.019 CrossRefPubMedGoogle Scholar
  29. 29.
    Ma HL, Blanchet TJ, Peluso D, Hopkins B, Morris EA, Glasson SS (2007) Osteoarthritis severity is sex dependent in a surgical mouse model. Osteoarthr cartil 15(6):695–700. doi: 10.1016/j.joca.2006.11.005 CrossRefPubMedGoogle Scholar
  30. 30.
    Riggs BL (2000) The mechanisms of estrogen regulation of bone resorption. J Clin Investig 106(10):1203–1204. doi: 10.1172/jci11468 CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Tuck SP, Francis RM (2009) Testosterone, bone and osteoporosis. Front Horm Res 37:123–132. doi: 10.1159/000176049 CrossRefPubMedGoogle Scholar
  32. 32.
    Muller DC, Giles GG, Bassett J, Morris HA, Manning JT, Hopper JL, English DR, Severi G (2011) Second to fourth digit ratio (2D: 4D) and concentrations of circulating sex hormones in adulthood. Reprod Biol Endocrinol 9:57. doi: 10.1186/1477-7827-9-57 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health ProfessionsBen-Gurion University of the NegevBeer ShevaIsrael
  2. 2.Research Institute and Museum of AnthropologyMoscow State UniversityMoscowRussia
  3. 3.Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Lilian and Marcel Pollak Chair of Biological AnthropologyTel Aviv UniversityTel AvivIsrael

Personalised recommendations