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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

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
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
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=18) assessed in the Chingford Women Study 23year visit (mean (SD) for age: 75.5years (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.
1757-1146
McQueen, Peter
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Gates, Lucy
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Marshall, Michelle
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Doherty, Michael
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Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Bowen, Catherine
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
McQueen, Peter
7d3e3eef-0eeb-4b9b-a3dd-8d36c2ac53ad
Gates, Lucy
bc67b8b8-110b-4358-8e1b-6f1d345bd503
Marshall, Michelle
2d82ae72-5e91-4844-a511-ab4a4663ebe0
Doherty, Michael
ab3e38b1-4e66-48b0-ae34-ec710c4fce2c
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Bowen, Catherine
fd85c3c5-96d9-49b8-86c6-caa94e1a222b

McQueen, Peter, Gates, Lucy, Marshall, Michelle, Doherty, Michael, Arden, Nigel and Bowen, Catherine (2017) 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. Journal of Foot and Ankle Research, 10 (1), [54]. (doi:10.1186/s13047-017-0239-9).

Record type: Article

Abstract

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=18) assessed in the Chingford Women Study 23year visit (mean (SD) for age: 75.5years (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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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 - Accepted Manuscript
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Accepted/In Press date: 27 November 2017
e-pub ahead of print date: 8 December 2017
Published date: 8 December 2017

Identifiers

Local EPrints ID: 417100
URI: http://eprints.soton.ac.uk/id/eprint/417100
ISSN: 1757-1146
PURE UUID: 2a2a3baf-699d-4114-881c-c31cefa04a50
ORCID for Lucy Gates: ORCID iD orcid.org/0000-0002-8627-3418
ORCID for Catherine Bowen: ORCID iD orcid.org/0000-0002-7252-9515

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Date deposited: 19 Jan 2018 17:30
Last modified: 22 Nov 2021 03:00

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Contributors

Author: Peter McQueen
Author: Lucy Gates ORCID iD
Author: Michelle Marshall
Author: Michael Doherty
Author: Nigel Arden
Author: Catherine Bowen ORCID iD

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