Prevalence and Associations of Hallux Valgus in a Primary Care Population

SLR - August 2009 - Jennifer Bell

Reference:
Roddy, E., Zhang W., Doherty M. (2008). Prevalence and associations of hallux valgus in a primary care population. Arthritis and Rheumatism, 59, 857-862.


Scientific Literature Reviews


Reviewed by: Jennifer Bell, DPM
Residency Program: OCPM-UHHS Richmond Medical Center


Podiatry relevance:
This study provides the prevalence of hallux valgus in a primary care population cohort, as well as contributing factors of hallux valgus development.

Methods:
This was a cross sectional study from 2 primary care practices. Questionnaires were mailed to 13, 684 patients greater than 30 years of age. Basic demographic information including age, sex, height and weight were collected. Self reported hallux valgus, nodal arthritis and knee pain were assessed utilizing a validated line drawing instrument. Patients also noted presence or absence of hallux pain, joint replacement, arthritis or rheumatoid arthritis. Exclusion criteria included major psychiatric disease, dementia or recently diagnosed malignancy. Results were analyzed to determine prevalence of self reported hallux valgus and to examine the factors associated with the pathology.

Results:
Responses were received from 4, 249 patients. 1, 194 patients (31%) reported hallux valgus. Women were noted to have greater prevalence than men across all age groups, 38% and 21% respectively. Bilateral hallux valgus was also noted to be more commonly reported than unilateral hallux valgus in both men and women. Prevalence of hallux valgus also increased with age for both unilateral and bilateral hallux valgus. Standard prevalence of hallux valgus for age group 40-80 years of age was 28.4%.
Associated factors of hallux valgus were noted to be age, female sex, nodal arthritis, osteoarthritis and self-reported rheumatoid arthritis on multivariate analysis.

Conclusions:
This represents one of the largest epidemiological surveys of hallux valgus to date. Results concluded that hallux valgus in a primary care population is strongly associated
with age and female sex. Also, hallux valgus is associated with other arthritic based conditions including knee and big toe pain, self-reported osteoarthritis, self-reported rheumatoid arthritis and nodal arthritis. This suggests hallux valgus may be a component of generalized arthritis itself.