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.