Epidemiology [301–314]

Background: Compared with the knee, hip and hand, there has been relatively little research on the occurrence of symptomatic osteoarthritis (OA) of the foot and ankle in the general population. Our starting point was to systematically review international population prevalence estimates of foot and...

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Published in:	Rheumatology (Oxford, England) Vol. 49; no. suppl-1; pp. i147 - i152
Main Authors:	Thomas, Martin J., Peat, George, Roddy, Edward, Menz, Hylton B., Jordan, Kelvin P., Croft, Peter R., Docking, Rachael E., Fleming, Jane, Zhao, Jun, Brayne, Carol, Macfarlane, Gary J., Jones, Gareth T., Bedson, John, Martino, Orsolina I., Dugue, Audrey, Greenbank, Cathi, Evans, Bronwen, Diggle, Peter, Goodson, Nicky, Halsey, John, Bukhari, Marwan, Fenech, Valerie, Farrugia, Cecilia, Degaetano, James, Grixti, Charles, Borg, Andrew A., Prieto-Alhambra, Daniel, Javaid, M Kassim, Maskell, Joe, Judge, Andrew, Nevitt, Michael, Cooper, Cyrus, Arden, Nigel K, Hill, Jonathan C., Konstantinou, Kika, Egbewale, Bolaji E., Dunn, Kate M., Lewis, Martyn, van der Windt, Danielle, Zwierska, Irena, Packham, Jonathan C., Chambers, Thomas, Johansson, Helena, Goodson, Nicola, Halsey, John P., Bukhari, Marwan A., Fatima, Firdaus, Moots, Robert J., Rao, Uppuluri R., Goodson, Nicola J., Soni, Anushka, White, Kirsten, Kiran, Amit, Goulston, Lyndsey, Hart, Deborah, Spector, Tim, Kassim Javaid, M, Arden, Nigel K.
Format:	Journal Article
Language:	English
Published:	Oxford University Press 01-04-2010
Online Access:	Get full text
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Summary:	Background: Compared with the knee, hip and hand, there has been relatively little research on the occurrence of symptomatic osteoarthritis (OA) of the foot and ankle in the general population. Our starting point was to systematically review international population prevalence estimates of foot and ankle pain in adults aged 45 years and older—the age at which clinical OA typically emerges. Methods: The search strategy included electronic databases (Pubmed, EMBASE, AMED, CINAHL, Cochrane, PEDro and SportDiscus: inception to Oct 2009) and bibliographies of all potentially eligible studies and selected review articles. Full-text English language articles were included if they used a population sample frame, cross-sectional design or analysis and reported prevalence estimates for foot and/or ankle pain in adults aged over 45 years. Eligibility criteria were applied by two independent reviewers to titles, abstracts and full-text articles with consensus meeting to resolve disagreements. Where necessary authors were contacted to obtain additional data. Methodological quality was assessed using an agreed checklist. The following data were extracted from each article: study location, year of data collection, population and sampling characteristics, case definition of pain and prevalence estimates for each definition of foot and ankle pain, overall and for each age and gender stratum. Where possible, CIs were calculated for each prevalence estimate together with odds ratios for age- and gender- within each study. A best estimate of the prevalence of foot/ankle pain was obtained by narrowing the synthesis to methodologically sound studies that used a clinically meaningful and comparable case definition. Results: Of 5554 abstracts, 28 articles based on 27 studies were eligible (12 Europe, 5 Australia, 4 Asia, 3 North America, 3 Scandinavia), providing a total 254 prevalence estimates based on different case definitions and population substrata. Seven studies provided separate foot and ankle pain estimates. With few exceptions, the prevalence of foot pain and ankle pain increased with age for men and women. In all age strata over 45 years, the prevalence of foot pain and ankle pain tended to be higher in women than in men (median OR: 1.4, IQR: 1.2, 1.8). Based on 8 studies, the best estimate for the prevalence of foot/ankle pain on most days in adults aged 45 years and older was 10–20% for males and 15–30% for females. Conclusions: Frequent foot/ankle pain is common in middle and old age and likely to co-occur with other joint pains. The contribution of OA to this common, disabling symptom remains unclear and represents an important area for future research. Disclosure statement: All authors have declared no conflicts of interest.
Bibliography:	ArticleID:keq733 istex:46B6871955FCCD190EDF39053C319A32E16102B3 ark:/67375/HXZ-JVG3KTKB-N
ISSN:	1462-0324 1462-0332
DOI:	10.1093/rheumatology/keq733