La Trobe
213270_Downes,T_2018.pdf (86.55 kB)

Symptomatic Course of Foot Osteoarthritis Phenotypes: An 18-Month Prospective Analysis of Community-Dwelling Older Adults

Download (86.55 kB)
journal contribution
posted on 2021-11-26, 05:28 authored by Thomas J Downes, Linda Chesterton, Rebecca Whittle, Edward Roddy, Hylton MenzHylton Menz, Michelle Marshall, Martin J Thomas
Objective: Osteoarthritis (OA) is a heterogeneous disease, and symptom progression at the foot is unclear. This study investigated the symptomatic course of 3 predefined foot OA phenotypes over an 18-month period. Methods: The Clinical Assessment Study of the Foot is a community-based cohort of adults ages ≥50 years in North Staffordshire, UK. Participants who reported foot pain in a postal health survey and underwent radiographic assessment were mailed an 18-month followup survey. Changes in descriptive and symptomatic outcomes over 18 months were compared across the 3 phenotypes to determine within-phenotype changes and between-phenotype differences. Results: Of 533 participants at baseline, 478 (89.7%) responded at 18 months. All 3 phenotypes showed small within-phenotype improvements in mean foot pain severity (scale range 0–10, where 0 = no pain and 10 = worst pain): no or minimal foot OA (18 months 4.0, mean change −1.15 [95% confidence interval (95% CI) −1.46, −0.83]), isolated first metatarsophalangeal (MTP) joint OA (18 months 4.1, mean change −0.60 [95% CI −1.11, −0.10]), and polyarticular foot OA (18 months 5.1, mean change −0.77 [95% CI −1.42, −0.12]). The isolated first MTP joint OA phenotype had an increased likelihood of hallux valgus in the left foot (adjusted odds ratio 2.96 [95% CI 1.23, 7.12]) compared to the no or minimal foot OA phenotype. Conclusion: Three foot OA phenotypes showed few descriptive or symptomatic changes over 18 months. Future clinical trials should consider that people recruited with mild-to-moderate symptomatic foot OA appear likely to remain relatively stable with usual care. Longer-term followup using additional time points is required to describe further the natural history of foot OA.


This project was undertaken with the support of the Keele Clinical Trials Unit at Keele University in the UK. The authors thank the staff of the participating general practices and the Haywood Hospital, particularly Dr. Saklatvala, Carole Jackson, and the radiographers at the Department of Radiography. The authors also thank Adam Garrow and the University of Manchester for granting permission to use the foot manikin


Publication Date



Arthritis Care & Research






6p. (p. 1107-1112)





Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

Usage metrics

    Journal Articles


    No categories selected



    Ref. manager