The radiological prevalence of degenerative arthritis of the 1st metatarsophalangeal joint

N. Howard, C. Cowan, S. Platt

Introduction: The prevalence of osteoarthritis of the 1st metatasphalangeal (mtpj) joint has been incompletely defined in a population-based study. The aim of the study was to determine the age and gender related prevalence of radiological 1st mtpj arthritis.

Methods: 517 consecutive radiographs of adult patients who presented with acute foot injuries to the accident and emergency department over a six month period were used. X rays were assessed independantly by the 2 authors using the Hattrup and Johnson grading system for osteoarthritic changes in the 1st MTPJ. Grade 1 - mild osteophytes with good joint space preservation, grade 2 - moderate osteophyte formation with joint space narrowing and subchondral sclerosis and grade 3 - marked osteophytes with loss of visible joint space, with or without subchondral bone cysts. If there was a discrepancy between the 2 authors results the x ray was graded by a consultant radiologist.

Results: The radiographic prevalence of MTPJ arthritis in our population was 25%. Overall incidence was higher in females with 31% affected in comparison to 18% of males. Variance between the 2 sexes was insignificant until the age of 60 where the prevalence rose to 66% in females compared to 47% in males of the same age.

Conclusions: The development of 1st MTPJ arthritis follows a typical pattern as degenerative arthritis in other joints, with increasing age being an important factor. The results of this study suggest that it is a condition that begins to appear in most cases in middle age and is more apparent in females.