title: 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: OBJECTIVE
  To 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.
  
  
  METHODS
  9334 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.
  
  
  RESULTS
  5109 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.
  
  
  CONCLUSIONS
  While 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.
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Roddy
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Thomas
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Marshall
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Trishna
authors.initials: T
authors.lastname: Rathod
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Myers
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK Lower Extremity and Gait Studies Program, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia.
authors.forename: Hylton B
authors.initials: HB
authors.lastname: Menz
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Thomas
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: George
authors.initials: G
authors.lastname: Peat
mesh_terms: D000368:Aged; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging*; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011859:Radiography; D013223:Statistics as Topic; D006113:United Kingdom / Q000453:epidemiology
keywords: Arthritis; Epidemiology; Osteoarthritis