Roddy Edward, Thomas Martin J, Marshall Michelle, Rathod Trishna, Myers Helen, Menz Hylton B, Thomas Elaine, Peat George
Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.
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.
Ann Rheum Dis. 2015 Jan;74(1):156-63. doi: 10.1136/annrheumdis-2013-203804. Epub 2013 Nov 19.
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.
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.
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.
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.
评估社区居住的老年人中，影响第一跖趾关节（MTPJ）、第一和第二楔跖关节（CMJ）、舟楔关节（NCJ）和距舟关节（TNJ）的有症状的影像学骨关节炎（OA）的人群患病率。
向在四个普通诊所登记的9334名年龄≥50岁的成年人邮寄了一份健康调查问卷。邀请在过去12个月内报告足部疼痛的受访者进行双足负重背跖位和侧位X线摄影。使用经过验证的图谱对第一MTPJ、第一和第二CMJ、NCJ和TNJ的OA进行分级。使用多重插补和加权逻辑回归模型计算有症状的影像学足部OA总体以及每个关节的人群患病率估计值，以处理缺失数据和无应答情况。
共收到5109份健康调查问卷（调整后应答率为56%）。对557名参与者进行了X线摄影。有症状的影像学OA的总体人群患病率为16.7%（95%CI 15.3%至18.0%），第一MTPJ为7.8%（6.7%至8.9%），第一CMJ为3.9%（2.9%至4.9%），第二CMJ为6.8%（5.7%至7.8%），NCJ为5.2%（4.0%至6.4%），TNJ为5.8%（4.8%至6.9%）。除第一CMJ外，女性患病率高于男性，患病率随年龄增长而增加，在社会经济地位较低的阶层中更高。四分之三有症状的影像学OA患者报告有足部致残症状。
尽管由于无应答情况需要谨慎解释，但我们的研究表明，有症状的影像学足部OA影响六分之一的老年人，且大多数人报告有相关残疾。临床医生应将OA视为老年人慢性足部疼痛的可能原因。
