Diagnostic Rule for Osteoarthritis in Foot Pain
Author Information
Author(s): Zammit Gerard V, Munteanu Shannon E, Menz Hylton B
Primary Institution: Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University
Hypothesis
Can a diagnostic rule be developed to identify radiographic osteoarthritis in people with first metatarsophalangeal joint pain?
Conclusion
A model with five clinical observations can accurately identify radiographic osteoarthritis in people with first metatarsophalangeal joint pain.
Supporting Evidence
- Pain duration greater than 25 months is significantly associated with radiographic OA.
- The presence of a dorsal exostosis is significantly associated with radiographic OA.
- A hard-end feel is significantly associated with radiographic OA.
- Crepitus is significantly associated with radiographic OA.
- Less than 64 degrees of first MTPJ dorsiflexion is significantly associated with radiographic OA.
- The statistically optimal model and clinical model both had an area under the curve of 0.87.
Takeaway
Doctors can use a simple checklist of symptoms to tell if someone has arthritis in their big toe joint, which can help them decide if an X-ray is needed.
Methodology
Symptoms and clinical observations were documented in 181 people, and the presence of OA was confirmed using radiography; multivariate logistic regression was used to develop diagnostic models.
Statistical Information
Confidence Interval
95% CI 0.81 to 0.93
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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