The effect of variation in interpretation of the La Trobe radiographic foot atlas on the prevalence of foot osteoarthritis in older women: the Chingford general population cohort.

Publisher: Wiley Country of Publication: England NLM ID: 101471610 Publication Model: eCollection Cited Medium: Internet ISSN: 1757-1146 (Electronic) Linking ISSN: 17571146 NLM ISO Abbreviation: J Foot Ankle Res Subsets: MEDLINE

Publication: 2024- : [Hoboken, NJ] : Wiley
Original Publication: London : BioMed Central, 2008-

Prevalence*; Foot/*diagnostic imaging ; Osteoarthritis/*diagnostic imaging ; Radiography/*methods; Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Humans ; Middle Aged ; Osteoarthritis/epidemiology ; Osteoarthritis/pathology ; Prospective Studies

Background: The prevalence of foot osteoarthritis (OA) is much less understood than hip, knee and hand OA. The foot is anatomically complex and different researchers have investigated different joints with lack of methodological standardisation across studies. The La Trobe Foot Atlas (LFA) is the first to address these issues in providing quantitative assessment of radiographic foot OA, but has not been tested externally. The aim of this study was to evaluate three different interpretive approaches to using the LFA for grading OA when scoring is difficult due to indistinct views of interosseous space and joint contour.
Methods: Foot radiographs of all remaining participants ( n  = 218) assessed in the Chingford Women Study 23 year visit (mean (SD) for age: 75.5 years (5.1)) were scored using the LFA defined protocol (Technique 1). Two revised scoring strategies were applied to the radiographs in addition to the standard LFA analyses. Technique 2 categorised joints that were difficult to grade as 'missing'. Technique 3 included joints that were difficult to grade as an over estimated score. Radiographic OA prevalence was defined for the foot both collectively and separately for individual joints.
Results: When radiographs were scored using the LFA (Technique 1), radiographic foot OA was present in 89.9%. For Technique 2 the presence of radiographic foot OA was 83.5% and for Technique 3 it was 97.2%. At the individual joint level, using Technique 1, the presence of radiographic foot OA was higher with a wider range (18.3-74.3%) than Technique 2 (17.9-46.3%) and lower with a wider range (18.3-74.3%) than Technique 3 (39.9-79.4%).
Conclusion: The three different ways of interpreting the LFA scoring system when grading of individual joints is technically difficult and result in very different estimates of foot OA prevalence at both the individual joint and global foot level. Agreement on the best strategy is required to improve comparability between studies.

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CDF-2015-08-032 United Kingdom DH_ Department of Health; G0501798 United Kingdom MRC_ Medical Research Council

Keywords: Arthritis; Diagnosis; Feet; Foot; Joints; Osteoarthritis; Prevalence

Date Created: 20171214 Date Completed: 20180205 Latest Revision: 20220311

20231215

PMC5723087

10.1186/s13047-017-0239-9

29234466