The natural history of radiographic first metatarsophalangeal joint osteoarthritis

NewsBot · Jun 26, 2019

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The natural history of radiographic first metatarsophalangeal joint osteoarthritis: a nineteen-year population based cohort study.
Bowen C et al
Arthritis Care Res (Hoboken). 2019 Jun 24

OBJECTIVE:
To assess the long-term prevalence, natural history, progression and incidence of radiographic first metatarsophalangeal joint (1st MTPJ) osteoarthritis (OA).

METHODS:
A longitudinal, cohort design was used in which radiographic OA at the 1st MTPJ was investigated in participants at year 6 (1995) and year 23 (2013-2015) from the Chingford 1000 Women study. Radiographic features of osteophytes (OPs) and/or joint space narrowing (JSN) at the 1st MTPJ 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 1st MTPJ.

RESULTS:
Complete case matched foot radiographic data were available for 193 of the women currently enrolled in the study, mean age: 75.7 years (SD: 5.2; range 69-90). At the level of the 1st MTPJ, prevalence of OA at year 6 was 21.76% in the left and 24.35% in the right and at year 23 was 23.83% in the left and 32.64% in the right. Over the 19-year period, 13.5% of women developed incident OA in the right 1st MTPJ and 8.3% in the left. Both progression and worsening of OA were more evident for OPs and in the right 1st MTPJs.

CONCLUSION:
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. Progression and/or worsening of 1st MTPJ OA over time appears to be driven by OP development rather than JSN suggestive of a biomechanical cause
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NewsBot · May 1, 2020

Structural characteristics associated with radiographic severity of first metatarsophalangeal joint osteoarthritis.
Buldt AK et al
Arthritis Care Res (Hoboken). 2020 Apr 27

OBJECTIVE:
To determine whether foot structure varies according to the presence and radiographic severity of first metatarsophalangeal joint osteoarthritis (first MTPJ OA).

METHODS:
Weight-bearing dorso-plantar and lateral radiographs were obtained for the symptomatic foot of 185 participants (105 females, aged 22 to 85 years) with clinically diagnosed first MTPJ OA. A validated atlas was used to classify participants as having radiographic first MTPJ OA and to stratified into three categories of severity (none/mild, moderate, severe). Bone length, width and angular measures of the forefoot and medial arch were performed on radiographs, and differences between categories were compared using univariate general linear models, adjusting for confounders.

RESULTS:
One hundred and fifty participants were categorised as having radiographic first MTPJ OA, and participants were further stratified into none/mild (n = 35), moderate (n = 69) or severe (n = 81) OA categories. Participants with radiographically defined first MTPJ OA displayed a greater hallux abductus interphalangeal angle. Increasing radiographic severity of first MTPJ OA was associated with a larger hallux abductus interphalangeal angle, wider first metatarsal and proximal phalanx and smaller intermetatarsal angle. No differences in medial arch measurements were observed between the categories.

CONCLUSION:
First ray alignment and morphology differ according to the presence and severity of first MTPJ OA. Prospective studies are required to determine whether the observed differences are a cause or consequence of OA.
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NewsBot · Jul 13, 2021

Characterisation of first metatarsophalangeal joint osteoarthritis using magnetic resonance imaging
Shannon E Munteanu et al
Clin Rheumatol. 2021 Jul 9

Introduction/objectives: First metatarsophalangeal joint (MTP) joint osteoarthritis (OA) is prevalent, although the pathology of this condition is poorly understood. This study aimed to determine if there were differences in magnetic resonance imaging (MRI) characteristics of the first MTP joint between individuals with and without first MTP joint OA.

Method: This cross-sectional study compared 22 participants with first MTP joint OA to 22 control participants without first MTP joint OA (matched for age, sex, and body mass index). Participants underwent MRI of their first MTP joint and osteophytes, bone marrow lesions, subchondral cysts, effusion-synovitis, joint space narrowing, and cartilage loss were documented using an atlas of first MTP joint OA. Associations of MRI characteristics with the presence of first MTP joint OA were then determined.

Results: The presence of first MTP joint OA was associated with increased severity of osteophytes (dorsal metatarsal head, plantar metatarsal head, and dorsal proximal phalanx), bone marrow lesions (metatarsal head and proximal phalanx), cysts of the metatarsal head, effusion-synovitis (dorsal aspect), joint space narrowing (metatarsal-proximal phalanx; metatarsal-sesamoids), and cartilage loss. In contrast, there were no statistically significant associations for bone marrow lesions of the sesamoids, cysts of the proximal phalanx, or effusion-synovitis (plantar aspect).

Conclusions: Osteophytes, bone marrow lesions, subchondral cysts, effusion-synovitis, joint space narrowing, and cartilage loss are characteristic MRI features of first MTP joint OA. First MTP joint OA is a disease of multiple joint tissues and this has implications for the assessment and management of this condition. Key Points • First metatarsophalangeal joint osteoarthritis is a disease of multiple joint tissues. • Osteophytes, bone marrow lesions, subchondral cysts, effusion-synovitis, joint space narrowing, and cartilage loss are characteristic MRI features of first metatarsophalangeal joint osteoarthritis. • These findings have implications for the assessment and management of this condition.
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NewsBot · Sep 21, 2023

Bone shape and alignment analysed using statistical shape modelling is associated with severity of first metatarsophalangeal joint osteoarthritis
Andrew K Buldt et al
Arthritis Care Res (Hoboken). 2023 Sep 20

Objective: To explore the relationship between bone shape and radiographic severity in individuals with first metatarsophalangeal joint osteoarthritis (first MTP joint OA).

Methods: Weightbearing lateral and dorso-plantar radiographs were obtained for the symptomatic foot of 185 participants (105 females, aged 22 to 85 years) with clinically diagnosed first MTP joint OA. Participants were classified into either none/mild, moderate, or severe categories using a standardised atlas. An 80-point model for lateral radiographs and 77-point model for dorso-plantar radiographs was used to define independent modes of variation using statistical shape modelling software. Odds ratios adjusted for confounders were calculated using ordinal regression to determine the association between radiographic severity and mode scores.

Results: After assessment and grading of radiographs, 35 (18.9%) participants were included in the none/mild first MTP joint OA severity category, 69 (37.2%) in the moderate severity, and 81 (43.7%) in the severe category. For lateral view radiographs, 16 modes of variation were included, which collectively represented 83.2% of total shape variance. Of these, four modes were associated with radiographic severity. For dorso-plantar view radiographs, 15 modes of variation were included, representing 82.6% of total shape variance. Of these, six modes were associated with radiographic severity.

Conclusions: Variations in the shape and alignment of the medial cuneiform, first metatarsal, proximal and distal phalanx of the hallux are significantly associated with radiographic severity of first MTP joint OA. Prospective studies are required to determine whether bone shape characteristics are associated with the development and/or progression of this condition.
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