['To determine the impact of limitations in daily activities and pain on quality of life (QoL) in patients with osteoarthritis (OA) visiting a rheumatologist.', 'Patients diagnosed by the rheumatologist with primary hand, knee or hip OA were consecutively included from August 2005 to April 2009. QoL was assessed by Short Form-36, with the physical component summary score (PCS), calculated using data from a norm-based population. Self-reported pain and function in patients with hand OA was assessed by the Australian/Canadian OA hand index (AUSCAN) pain (range 0-20) and AUSCAN function (range 0-36). Linear regression analyses were performed to investigate associations between PCS and demographic characteristics, and between PCS and pain and function in patients with OA.', 'Hand OA was diagnosed in 95% of 460 included patients (89% women, mean age 61 years). PCS was lowered in patients with OA. Patients with hand OA reported a considerable amount of pain (mean 9.5 (SD 4.3)) and disability (mean 16.5 (SD 8.6)). AUSCAN function was associated with PCS (adjusted β=-0.3, 95% CI -0.4 to -0.2), but AUSCAN pain was not.'] Are limitations in daily activities the major determinant of reduced health-related quality of life in patients with hand osteoarthritis?