title: Hyaline cartilage calcification of the first metatarsophalangeal joint is associated with osteoarthritis but independent of age and BMI.
abstract: Hyaline cartilage calcification (CC) is associated with osteoarthritis (OA) in hip and knee joints. The first metatarsophalangeal joint (1stMTPJ) is frequently affected by OA, but it is unclear if CC occurs in the 1stMTPJ. The aim of the present study was to analyze the prevalence of CC of the 1stMTPJ in the general population by high-resolution digital contact radiography (DCR) and to determine its association with histological OA severity, age and body mass index (BMI).
  
  
  
  168 metatarsal heads of 84 donors (n = 47 male, n = 37 female; mean age 62.73 years, SD ±18.8, range 20-93) were analyzed by DCR for the presence of CC. Histological OA grade (hOA) by OARSI was analyzed in the central load-bearing zone of the first metatarsal head (1stMH). Structural equation modeling (SEM) was performed to analyze the interrelationship between CC, hOA, age and BMI.
  
  
  
  The prevalence of CC of 1stMH was 48.8 % (41/84) (95 %-CI [37.7 %, 60.0 %]), independent of the affected side (p = 0.42), gender (p = 0.41) and BMI (p = 0.51). The mean amount of CC of one MH correlated significantly with that of the contralateral side (rs= 0.4, 95 %-CI [0.26, 0.52], p < 0.001). The mean amount of CC (in % of total cartilage area) of the MH correlated significantly with the severity of hOA (rs= 0.51, 95 %-CI [0.32, 0.65], p < 0.001). SEM revealed significant associations between CC and hOA (r = 0.74, p < 0.001) and between hOA and age (β = 0.62, p = 0.001), but not between CC and age (p = 0.15). There was no significant influence of BMI on either CC (p = 0.37) or hOA (p = 0.16).
  
  
  
  The observation that CC of the 1stMH is significantly associated with the severity of OA but independent of age and BMI, suggests an intimate relationship between CC and the pathogenesis of OA, the exact nature of which will have to be explored by future studies.
authors.affiliation: Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany. j.hubert@uke.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Hubert
authors.affiliation: Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany. t.hawellek@uke.de.
authors.forename: Thelonius
authors.initials: T
authors.lastname: Hawellek
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Hischke
authors.affiliation: Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Domagkstrasse 3, Münster, 48149, Germany.|Department of Orthopaedic Surgery, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Magdeburg, 39120, Germany.
authors.forename: Jessica
authors.initials: J
authors.lastname: Bertrand
authors.affiliation: Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestraße 59, Hamburg, 22529, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Krause
authors.affiliation: Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Püschel
authors.affiliation: Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rüther
authors.affiliation: Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Niemeier
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002114:Calcinosis / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D051457:Hyaline Cartilage / Q000473:pathology*; D008297:Male; D008683:Metatarsophalangeal Joint / Q000473:pathology* / Q000502:physiology*; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000473:pathology; D015995:Prevalence; D011859:Radiography / Q000379:methods; D012720:Severity of Illness Index; D016474:Weight-Bearing; D055815:Young Adult
keywords: Age; BMI; Cartilage calcification; Hallux; Hyaline cartilage; Osteoarthritis; metatarsophalangeal joint