The population prevalence of symptomatic radiographic foot osteoarthritis in community-dwelling older adults: cross-sectional findings from the Clinical Assessment Study of the Foot

Abstract

ObjectivesTo estimate the population prevalence of symptomatic radiographic osteoarthritis (OA) affecting the 1st metatarsophalangeal joint (MTPJ), 1st and 2nd cuneometatarsal joints (CMJs), navicular first cuneiform joint (NCJ) and talonavicular joint (TNJ) in community-dwelling older adults.Methods9334 adults aged ≥50 years registered with four general practices were mailed a health survey. Responders reporting foot pain within the last 12 months were invited to undergo weight-bearing dorso-plantar and lateral radiographs of both feet. OA at the 1st MTPJ, 1st and 2nd CMJs, NCJ and TNJ was graded using a validated atlas. Population prevalence estimates for symptomatic radiographic foot OA overall and for each joint were calculated using multiple imputation and weighted logistic regression modelling to account for missing data and non-response.Results5109 health surveys were received (adjusted response 56%). Radiographs were obtained on 557 participants. Overall population prevalence of symptomatic radiographic OA was 16.7% (95% CI 15.3% to 18.0%), 1st MTPJ 7.8% (6.7% to 8.9%), 1st CMJ 3.9% (2.9% to 4.9%), 2nd CMJ 6.8% (5.7% to 7.8%), NCJ 5.2% (4.0% to 6.4%) and TNJ 5.8% (4.8% to 6.9%). With the exception of the 1st CMJ, prevalence was greater in females than males, increased with age and was higher in lower socioeconomic classes. Three-quarters of those with symptomatic radiographic OA reported disabling foot symptoms.ConclusionsWhile cautious interpretation due to non-response is warranted, our study suggests that symptomatic radiographic foot OA affects one in six older adults and the majority report associated disability. Clinicians should consider OA as a possible cause of chronic foot pain in older people.

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

“…Sixty randomly selected radiographs were rescored after 8 weeks (by MM) to assess intrarater reliability and were scored by a second experienced reader (HBM) to determine interrater reliability. As reported previously, reliability for the presence of OA was excellent for intrarater (mean κ = 0.94; mean % exact agreement 99%) and moderate for interrater reliability (mean κ = 0.46; mean % exact agreement 79%) 7.…”

“…Responders to the health survey reporting pain in or around the foot within the last year and who consented to further contact were invited to attend a research clinic 12. A flowchart showing the recruitment of participants to the CASF study has been published previously 7.…”

“…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). While it remains the case that the first MTP joint is most commonly implicated in foot OA, these observations could be consistent with 2 quite different scenarios, both of which carry implications for how foot OA is understood and managed: either there are forms of OA at the foot that occur independently, or first MTP joint OA is associated with OA at other proximal joints in the foot as part of a more widespread polyarticular presentation.…”

098. Erosive and Osteoarthritic Structural Progression in Early Rheumatoid Arthritis

“…Summated joint scores for the whole hand, DIP and PIP joints had inter- scorer (MM) using 60 pairs of feet from the CAS-F study (26). For summated OST scores, interobserver ICC (95% CI) was 0.81 (0.69 -0.89), and intra-observer ICC (95% CI) was 0.84 (0.58 -0.94)).…”

“…Analysis after the inclusion of ESR, SJC, TJC and VAS-GH, and removal of DAS28 and DAS28-P, showed that erosions were associated with higher ESR (1.77 (1. 26 …”