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The Discrepancy between Radiographically assessed and Self-recognized Hallux Valgus in a
Large Population-based Cohort
Takumi Matsumoto et al
Research Square
Background: There has been a paucity of literature revealing the discrepancy between self-recognition
about hallux valgus (HV) and radiographically-evaluated foot configuration.
Questions/Purposes: (1) Is there a discrepancy between radiographically-assessed and self-recognized
HV in the general population? (2) What factors affect the self-recognition of HV in the general population?
Methods: The fifth survey of the Research on Osteoarthritis/Osteoporosis against Disability study
involved 1996 participants who had undergone anterior-posterior radiography of bilateral feet and
answered an interviewer-administered questionnaire on self-recognition of HV. Measurements of the HV
angle (HVA) and interphalangeal angle of the hallux (IPA) were performed using radiographs. After
univariate comparison of the participant backgrounds and radiographic measurements between
participants with or without self-recognition of HV, multivariable logistic regression analysis was
conducted in order to reveal independent factors affecting self-recognition.
Results: The mean HVA and IPA were 16.8°and 15.4°, respectively. Significant difference was found
between the prevalence of radiographically-assessed and self-recognized HV (29.8% vs. 16.5%, p <
0.0001). The prevalence of self-recognized HV increased with the progression of HV severity from a
single-digit percentage (normal grade, HVA < 20°) up to 100% (severe grade, HVA ≥ 40°). A multivariable
logistic regression analysis demonstrated that HVA and female sex were independent positive factors for
self-recognition of HV (HVA [per 1° increase]: OR, 1.20; 95% CI, 1.18-1.22; p < 0.0001; and female sex [vs.
male sex]: OR, 3.17; 95% CI, 2.14-4.73; p < 0.0001).
Conclusions: There was a significant discrepancy between radiographically-assessed and self-recognized
HV which narrowed with the progressing severity of HV. HVA and female sex were independent positive
factors for self-recognition of HV.
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