Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

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. This article is protected by copyright. All rights reserved.

Original publication




Journal article


Arthritis care res (hoboken)

Publication Date



Feet, Foot, Joints, Natural history, Osteoarthritis