A systematic review of radiographic definitions of foot osteoarthritis in population-based studies

Trivedi, Bavia; Marshall, Michelle; Belcher, John; Roddy, Edward

doi:10.1016/j.joca.2010.05.005

Cited by 52 publications

(58 citation statements)

References 48 publications

(95 reference statements)

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“…With few exceptions, population‐based epidemiologic studies have focused on the metatarsophalangeal (MTP) joints, predominantly the first MTP, for the purpose of estimating prevalence 4. Using a recently developed radiographic atlas for semiquantitative scoring of plain radiographs of the feet 5, Menz et al 6 and Roddy et al 7 have observed the frequent occurrence of osteophytes or joint space narrowing (JSN) in joints located in the medial column of the midfoot (specifically, the second cuneometatarsal [CM] joint, talonavicular [TN] joint, and navicular first cuneiform [NC] joints).…”

Section: Introductionmentioning

confidence: 99%

Investigations of Potential Phenotypes of Foot Osteoarthritis: Cross‐Sectional Analysis From the Clinical Assessment Study of the Foot

Rathod

Marshall

Thomas

et al. 2016

Arthritis Care & Research

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ObjectiveTo investigate the existence of distinct foot osteoarthritis (OA) phenotypes based on pattern of joint involvement and comparative symptom and risk profiles.MethodsParticipants ages ≥50 years reporting foot pain in the previous year were drawn from a population‐based cohort. Radiographs were scored for OA in the first metatarsophalangeal (MTP) joint, first and second cuneometatarsal, navicular first cuneiform, and talonavicular joints according to a published atlas. Chi‐square tests established clustering, and odds ratios (ORs) examined symmetry and pairwise associations of radiographic OA in the feet. Distinct underlying classes of foot OA were investigated by latent class analysis (LCA) and their association with symptoms and risk factors was assessed.ResultsIn 533 participants (mean age 64.9 years, 55.9% female) radiographic OA clustered across both feet (P < 0.001) and was highly symmetrical (adjusted OR 3.0, 95% confidence interval 2.1, 4.2). LCA identified 3 distinct classes of foot OA: no or minimal foot OA (64%), isolated first MTP joint OA (22%), and polyarticular foot OA (15%). After adjustment for age and sex, polyarticular foot OA was associated with nodal OA, increased body mass index, and more pain and functional limitation compared to the other classes.ConclusionPatterning of radiographic foot OA has provided insight into the existence of 2 forms of foot OA: isolated first MTP joint OA and polyarticular foot OA. The symptom and risk factor profiles in individuals with polyarticular foot OA indicate a possible distinctive phenotype of foot OA, but further research is needed to explore the characteristics of isolated first MTP joint and polyarticular foot OA.

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Section: Introductionmentioning

confidence: 99%

Investigations of Potential Phenotypes of Foot Osteoarthritis: Cross‐Sectional Analysis From the Clinical Assessment Study of the Foot

Rathod

Marshall

Thomas

et al. 2016

Arthritis Care & Research

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“…The prevalence of radiographic MTP I OA has been estimated to be from 6.3% to 39% in middle-aged and older adults [13]. Foot OA shares many risk factors with other forms of OA, like age and obesity.…”

Section: Introductionmentioning

confidence: 99%

TUFT1, a novel candidate gene for metatarsophalangeal osteoarthritis, plays a role in chondrogenesis on a calcium-related pathway

et al. 2017

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Osteoarthritis (OA) is the most common degenerative joint disorder and genetic factors have been shown to have a significant role in its etiology. The first metatarsophalangeal joint (MTP I) is highly susceptible to development of OA due to repetitive mechanical stress during walking. We used whole exome sequencing to study genetic defect(s) predisposing to familial early-onset bilateral MTP I OA inherited in an autosomal dominant manner. A nonsynonymous single nucleotide variant rs41310883 (c.524C>T, p.Thr175Met) in TUFT1 gene was found to co-segregate perfectly with MTP I OA. The role of TUFT1 and the relevance of the identified variant in pathogenesis of MTP I OA were further assessed using functional in vitro analyses. The variant reduced TUFT1 mRNA and tuftelin protein expression in HEK293 cells. ATDC5 cells overexpressing wild type (wt) or mutant TUFT1 were cultured in calcifying conditions and chondrogenic differentiation was found to be inhibited in both cell populations, as indicated by decreased marker gene expression when compared with the empty vector control cells. Also, the formation of cartilage nodules was diminished in both TUFT1 overexpressing ATDC5 cell populations. At the end of the culturing period the calcium content of the extracellular matrix was significantly increased in cells overexpressing mutant TUFT1 compared to cells overexpressing wt TUFT1 and control cells, while the proteoglycan content was reduced. These data imply that overexpression of TUFT1 in ATDC5 inhibits chondrogenic differentiation, and the identified variant may contribute to the pathogenesis of OA by increasing calcification and reducing amount of proteoglycans in the articular cartilage extracellular matrix thus making cartilage susceptible for degeneration and osteophyte formation.

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“…Up till now, it is unclear which radiological grading system is best for evaluating posttraumatic subtalar OA. To our knowledge, there is only one systematic review that evaluates the methods of grading foot OA [9]. This study showed that 70 % of studies describing OA in all foot and hindfoot joints use the Kellgren and Lawrence Grading System (KLGS).…”

Section: Introductionmentioning

confidence: 99%

Post-traumatic subtalar osteoarthritis: which grading system should we use?

Keizer

Backes

Dingemans

et al. 2016

International Orthopaedics (SICOT)

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Purpose To assess and compare post-traumatic osteoarthritis following intra-articular calcaneal fractures, one must have a reliable grading system that consistently grades the posttraumatic changes of the joint. A reliable grading system aids in the communication between treating physicians and improves the interpretation of research. To date, there is no consensus on what grading system to use in the evaluation of posttraumatic subtalar osteoarthritis. The objective of this study was to determine and compare the inter-and intra-rater reliability of two grading systems for post-traumatic subtalar osteoarthritis. Methods Four observers evaluated 50 calcaneal fractures at least one year after trauma on conventional oblique lateral, internally and externally rotated views, and graded posttraumatic subtalar osteoarthritis using the Kellgren and Lawrence Grading Scale (KLGS) and the Paley Grading System (PGS). Inter-and intra-rater reliability were calculated and compared. Results The inter-rater reliability showed an intra-class correlation (ICC) of 0.54 (95 % CI 0.40-0.67) for the KLGS and an ICC of 0.41 (95 % CI 0.26 -0.57) for the PGS. This difference was not statistically significant. The intra-rater reliability showed a mean weighted kappa of 0.62 for both the KLGS and the PGS. Conclusion There is no statistically significant difference in reliability between the Kellgren and Lawrence Grading System (KLGS) and the Paley Grading System (PGS). The PGS allows for an easy two-step approach making it easy for everyday clinical purposes. For research purposes however, the more detailed and widely used KLGS seems preferable.

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A systematic review of radiographic definitions of foot osteoarthritis in population-based studies

Abstract: There are comparatively few studies examining radiographic foot OA. Existing studies mainly focus on the first MTP joint and use the K&L grading system. Future studies are needed to quantify the prevalence of radiographic OA at the different joint complexes within the foot.

Cited by 52 publications

References 48 publications

Investigations of Potential Phenotypes of Foot Osteoarthritis: Cross‐Sectional Analysis From the Clinical Assessment Study of the Foot

Investigations of Potential Phenotypes of Foot Osteoarthritis: Cross‐Sectional Analysis From the Clinical Assessment Study of the Foot

TUFT1, a novel candidate gene for metatarsophalangeal osteoarthritis, plays a role in chondrogenesis on a calcium-related pathway

Post-traumatic subtalar osteoarthritis: which grading system should we use?

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