Demographic and clinical factors associated with radiographic severity of first metatarsophalangeal joint osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot.
OBJECTIVE
To explore demographic and clinical factors associated with radiographic severity of first metatarsophalangeal joint osteoarthritis (OA) (First MTPJ OA).


DESIGN
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 a clinical assessment and weight-bearing dorso-plantar and lateral radiographs of both feet. Radiographic first MTPJ OA in the most severely affected foot was graded into four categories using a validated atlas. Differences in selected demographic and clinical factors were explored across the four radiographic severity subgroups using analysis of variance (ANOVA) and ordinal regression.


RESULTS
Clinical and radiographic data were available from 517 participants, categorised as having no (n = 105), mild (n = 228), moderate (n = 122) or severe (n = 62) first MTPJ OA. Increased radiographic severity was associated with older age and lower educational attainment. After adjusting for age, increased radiographic first MTPJ OA severity was significantly associated with an increased prevalence of dorsal hallux and first MTPJ pain, hallux valgus, first interphalangeal joint (IPJ) hyperextension, keratotic lesions on the dorsal aspect of the hallux and first MTPJ, decreased first MTPJ dorsiflexion, ankle/subtalar joint eversion and ankle joint dorsiflexion range of motion, and a trend towards a more pronated foot posture.


CONCLUSIONS
This cross-sectional study has identified several dose-response associations between radiographic severity of first MTPJ OA and a range of demographic and clinical factors. These findings highlight the progressive nature of first MTPJ OA and provide insights into the spectrum of presentation of the condition in clinical practice.
['Menz|H B|HB|', 'Roddy|E|E|', 'Marshall|M|M|', 'Thomas|M J|MJ|', 'Rathod|T|T|', 'Myers|H|H|', 'Thomas|E|E|', 'Peat|G M|GM|']
D000368:Aged D003430:Cross-Sectional Studies D005260:Female D006801:Humans D008297:Male D008683:Metatarsophalangeal Joint D008875:Middle Aged D010003:Osteoarthritis D011446:Prospective Studies D011859:Radiography D012720:Severity of Illness Index D012959:Socioeconomic Factors
Osteoarthritis Foot Pain Epidemiology Radiography