Radiographic classification of osteoarthritis in commonly affected joints of the foot

Menz, Hylton B.; Munteanu, Shannon E.; Landorf, Karl B; Zammit, Gerard V; Cicuttini, Flavia Maria

doi:10.1016/j.joca.2007.05.007

Cited by 134 publications

(210 citation statements)

References 22 publications

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“…Intrarater reliability for the presence of OA was found to be excellent. Despite interrater reliability being moderate, it was comparable with the original atlas 5. Although the study population had a prevalence of OA in 1 or more foot joints of 63%, when multiple foot joints were examined the numbers in some of the combinations were quite small.…”

Section: Discussionmentioning

confidence: 52%

“…A single experienced reader (MM), who had undergone a period of training, scored 5 joints in each foot (first MTP joint, first and second CM joints, NC joint, and TN joint) for osteophytes and JSN (range 0–3) according to a published atlas 5. The joints examined were selected based on their inclusion in the published radiographic foot atlas, which had determined that they were the most commonly affected, clearly visible on dorsoplantar and lateral views, and could be reliably scored 5. 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.…”

Section: Methodsmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 52%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…17 The atlas consists of standardized dorso-plantar and lateral radiographs of commonly affected joints of the foot. For each joint, the presence of osteophytes was graded as absent (score ¼ 0), small (score ¼ 1), moderate (score ¼ 2) or severe (score ¼ 3), and presence of joint space narrowing was graded as none (score ¼ 0), definite (score ¼ 1), severe (score ¼ 2), or joint fusion of at least one point (score ¼ 3).…”

Section: Radiographic Assessmentmentioning

confidence: 99%

“…Classification of first MPJ OA using this atlas has been shown to have high test-retest and interexaminer reliability. 17 Assessment of First MPJ Motion First MPJ dorsiflexion was measured using a goniometer with participants in a seated position. The hallux was passively dorsiflexed to its end point range of motion with the amount of motion documented in degrees.…”

Section: Radiographic Assessmentmentioning

confidence: 99%

Plantar pressure distribution in older people with osteoarthritis of the first metatarsophalangeal joint (hallux limitus/rigidus)

Zammit

Menz

Munteanu

et al. 2008

Journal Orthopaedic Research

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The purpose of this study was to evaluate differences in dynamic plantar pressure distribution between older people with and without radiographically confirmed osteoarthritis (OA) of the first metatarsophalangeal joint (first MPJ) of the foot. Dynamic plantar pressure recordings using the TekScan MatScan 1 system were obtained during barefoot level walking in 40 older participants; 20 with radiographically confirmed OA of the first MPJ displaying less than 55 degrees of passive dorsiflexion, and 20 with no evidence of OA in the first MPJ displaying greater than 55 degrees of passive dorsiflexion. Group comparisons between the variables maximum force and peak pressure were made for seven different regions underneath the right foot (heel, midfoot, first MPJ, second MPJ, third to fifth MPJs, hallux, and lesser toes). Compared to the control group, participants with OA of the first MPJ exhibited 34% greater maximum force (7.9 AE 2.5 vs. 5.9 AE 1.7 kg, p ¼ 0.005) and 23% higher peak pressure (1.6 AE 0.3 vs. 1.3 AE 0.3 kg/cm 2 , p ¼ 0.001) under the hallux. Similar results were also found under the lesser toes with 43% greater maximum force (5.0 AE 1.9 vs. 3.5 AE 1.4 kg; p ¼ 0.006) and 29% higher peak pressure (0.9 AE 0.2 vs. 0.7 AE 0.2 kg/cm 2 , p ¼ 0.018). No significant differences were found to exist between groups for any other plantar region. These findings indicate that OA of the first MPJ is associated with significant changes in load-bearing function of the foot, which may contribute to the development of secondary pathological changes associated with the condition, such as plantar callus formation and hyperextension of the hallux interphalangeal joint. The first metatarsophalangeal joint (first MPJ) consists of four articular facets including the first metatarsal head, the base of the proximal phalanx and the superior surfaces of the medial and lateral sesamoids. 1 Structurally, the first MPJ is classified as a single synovial condyloid joint that allows sagittal plane motion, primarily dorsiflexion, to occur about a horizontal axis. Approximately 65 to 75 degrees of dorsiflexion is considered necessary to enable efficient forward transfer of bodyweight during the propulsive phase of gait. 2-4 It has been hypothesized that restricted first MPJ motion can alter foot function, leading to first MPJ pain and the development of secondary pathological foot conditions such as plantar calluses. [2][3][4] Through repetitive loading during gait, the first MPJ is subject to a significant amount of stress, making it susceptible to the development of degenerative joint disease (osteoarthritis). Osteoarthritis (OA) is the leading cause of chronic pain and disability of older people in developed countries, 5 with OA of the first MPJ affecting 35 to 60% of the population aged over 65 years. 6 Depending on the severity of joint degeneration, OA of the first MPJ is termed hallux limitus or hallux rigidus. 7-13 Hallux limitus is defined as a condition in which there is restricted sagittal plane motion, whereas hallux...

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Foot problems

Menz

2022

Pathy's Principles and Practice of Geriatric Medicine

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Radiographic classification of osteoarthritis in commonly affected joints of the foot

Cited by 134 publications

References 22 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

Plantar pressure distribution in older people with osteoarthritis of the first metatarsophalangeal joint (hallux limitus/rigidus)

Foot problems

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