Prevalence of imaging findings associated with osteoarthritis in dancers: A systematic review

Prevalence of imaging findings associated with osteoarthritis in dancers: A systematic review

Purpose: The purpose of this study was to systematically review the literature and synthesise evidence of the prevalence of imaging findings that may be associated with osteoarthritis (OA), and their relationship with symptoms in dance populations. Literature review: Studies have reported the prevalence and increased risk of dancers developing symptomatic OA, however many studies use a radiographic diagnosis of OA, and imaging findings can exist with or without symptoms or burden.
Methods: Studies were included that reported clinical joint findings on imaging in a dance population. Only cohort studies, cross sectional studies, and case control included studies are reported. Studies were excluded if; dance was utilised as an intervention, if imaging reports were related to trauma, or if systemic inflammatory or rheumatological conditions were present. Four electronic databases were searched to September 2023. Risk of bias assessment and data extraction were conducted by two independent reviewers. Data were pooled if studies reported on the same intra-articular imaging findings, at the same joint.
Results and Discussion: 33 studies reached inclusion: two cohort studies, 12 cross sectional studies and 19 case control studies. Meta-analysis was performed for the prevalence of hip, ankle, and first metatarsophalangeal joint OA and ankle effusion. The first metatarsophalangeal joint had the highest prevalence of radiographic OA, however, a low number of cases with radiographic OA reported symptoms. The ankle and then the hip joint were the next most common regions to report joint imaging findings. There were also reports of ankle effusion, hip cartilage lesions, labral lesions, and herniation pits found in dancers that could lead to early OA, but studies found no association between ankle and hip imaging findings and symptoms.
Conclusion: The highest prevalence of imaging findings was found in the first metatarsophalangeal joint followed by the ankle and hip joints; however, these findings do not appear to relate to symptoms. It appears that there is a similar prevalence of symptomatic OA in retired ballet dancers compared to global reports. Future research should focus on symptoms and their potential burden, and not imaging findings in isolation.

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