Radiological prevalence of degenerative arthritis of the first metatarsophalangeal joint.

BACKGROUND: The prevalence of osteoarthritis of the first metatarsophalangeal joint (MTPJ) has not been completely determined in a population-based study. The aim of the study was to determine the age- and gender-related prevalence of radiological first MTPJ arthritis. METHODS: We analyzed 517 consecutive radiographs of adult patients who presented with acute foot injuries to the accident and emergency department over a 6-month period. Radiographs were assessed independently by 2 authors using the Hattrup and Johnson grading system for osteoarthritic changes in the first MTPJ. RESULTS: The radiographic prevalence of MTPJ arthritis in our population was 25% (127/517). Overall incidence was higher in females, with 32% (85/269) of females affected in comparison to 18% (44/248) of males. Variance between the sexes was insignificant until the age of 60, at which point the prevalence rose to 66% (53/80) in females compared with 47% (18/38) in males of the same age. CONCLUSIONS: The development of first MTPJ arthritis follows a typical pattern of degenerative arthritis, as shown in other joints, with increasing age being an important factor. The results of this study suggest that first MTPJ arthritis begins to appear in most cases in middle age and is significantly more apparent in females. LEVEL OF EVIDENCE: Level III, comparative case series.

MRI measurements of the cervical spine and their correlation to Pavlov's ratio.

STUDY DESIGN: Pavlov's ratio from plain radiographs in patients with neck pain but no radicular symptoms was compared with the areas of the cervical spinal cord and cerebrospinal fluid column on magnetic resonance scans. SUMMARY OF BACKGROUND DATA: The area of the cervical canal or cord obviously depends on both the sagittal and transverse diameters. Although the pathology in stenosis of the cervical spine is mainly in the sagittal plane, narrowing only in the sagittal diameter may not indicate significant reduction in the area of the canal. The transverse area of the cord has been shown to correlate well with the pathologic changes of the cord in cervical myelopathy. We correlated Pavlov's ratio on the plain radiographs to the area of the cerebrospinal fluid column and the area of the cord on the magnetic resonance scan. METHODS: We examined the lateral radiographs and axial and sagittal T2-weighted magnetic resonance scans in the neutral position of the cervical spine (C4-C7) of 87 patients with 332 levels with neck pain but no radicular symptoms and normal magnetic resonance scans. On the magnetic resonance images, the sagittal diameters of the cerebrospinal fluid column and the cord were measured at the midvertebra level on T2 sagittal images from C4 to C7. From the T2 axial images, the area of the cord and the area of the cerebrospinal fluid column were measured at the same levels. RESULTS: The correlation between Pavlov's ratio and the area of cerebrospinal fluid column was moderate, with the highest value of 0.31 at C5. The sagittal diameter of the cerebrospinal fluid column showed variable correlation with the area of the cerebrospinal fluid column. The highest correlation was 0.68 between the sagittal diameter and the area of the cerebrospinal fluid column at C7. The correlation between Pavlov's ratio and the area of the cord is around zero, with the highest correlation of 0.21 at C4. The sagittal diameter of the cord showed a moderate correlation with the area of the cord. CONCLUSION: This study shows a poor correlation between Pavlov's ratio and the space available for the cord. Therefore, this ratio cannot be solely relied upon to predict the area changes in that plane of the cervical spinal canal.