Abstract
ObjectiveTo assess the long‐term prevalence, natural history, progression, and incidence of radiographic first metatarsophalangeal (MTP) joint osteoarthritis (OA).MethodsA longitudinal cohort design was used in which radiographic OA at the first MTP joint was investigated in participants from the Chingford 1,000 Women Study at year 6 (1995) and year 23 (2013–2015). Radiographic features of osteophytes (OPs) and/or joint space narrowing (JSN) at the first MTP joint were scored according to a validated foot atlas. Natural history was determined by the change in prevalence, incidence, progression, and worsening of OA in the first MTP joint.ResultsComplete case‐matched foot radiographic data were available for 193 of the women currently enrolled in the study (mean ± SD age 75.7 ± 5.2 years [range 69–90 years]). At the level of the first MTP joint, prevalence of OA at year 6 was 21.76% in the left and 24.35% in the right; at year 23, it was 23.83% in the left and 32.64% in the right. Over the 19‐year period, 13.5% of the women developed incident OA in the right first MTP joint and 8.3% in the left. Both progression and worsening of OA were more evident for OPs and in the right first MTP joints.ConclusionIn this study of the natural history of radiographic first MTP joint OA, which to our knowledge is the longest study to date, the prevalence and incidence of first MTP joint OA increased over a 19‐year period. Progression and/or worsening of OA at the first MTP joint over time appears to be driven by OP development rather than JSN, which suggests a biomechanical cause.
Highlights
There is increasing evidence from a growing number of population cohort studies that foot osteoarthritis (OA) is common, especially in older adults with foot pain [1,2,3,4]
In this longest study of the natural history of radiographic 1st MTPJ OA to date, the prevalence and incidence of 1st MTPJ OA increased over a 19-year period
This study is the first to do so over a nineteen-year period, confirming that the prevalence of radiographic osteoarthritis within the first metatarsophalangeal joint (1st MTPJ) in older women increases over time
Summary
There is increasing evidence from a growing number of population cohort studies that foot osteoarthritis (OA) is common, especially in older adults with foot pain [1,2,3,4]. The UK population prevalence of symptomatic radiographic foot OA overall has been estimated at 17% and, for the individual joint level, at 8% for the first metatarsophalangeal joints (1st MTPJ) in adults aged over 50 years [2]. Studies reporting on the incidence of OA of the knee and hip are becoming more evident [13,14,15]. In contrast to knee and hip OA, there are very few studies on the epidemiology of foot and ankle OA or their management. A recent study investigating self-reported foot pain over 18 months, reported little symptomatic changes in three different foot OA phenotypes determined at baseline [18]
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