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Background/Aims Foot and ankle involvement is common in rheumatic and musculoskeletal diseases (RMDs), but high-quality evidence is lacking to determine the effectiveness of foot and ankle treatments. Heterogeneity in the outcomes used across clinical trials in this area hinders the ability to compare study findings, and some outcomes are not always meaningful to patients. This study aimed to determine what outcomes are important to patients by exploring and synthesising qualitative data relating to the symptoms and impact of living with foot and ankle disorders in RMDs. Methods Six databases (CINAHL; Ovid Embase; Ovid MEDLINE; Psycinfo; Cochrane Database of Systematic Reviews; CENTRAL) were searched from inception to March 2022. Qualitative interview or focus group studies published in English and involving participants living with foot or ankle disorders in RMDs (inflammatory arthritis, osteoarthritis, crystal arthropathies, connective tissue diseases, and musculoskeletal conditions in the absence of systemic disease) were included. Quality was assessed using the Critical Appraisal Skills Programme qualitative tool. All data from the results section of included studies were extracted, coded and synthesised to develop themes. Patient and public involvement contributors were involved throughout the review, from design of the study to interpretation of the results and discussions about the findings. Results Of 1,440 database records screened, 34 studies were included, with a total of 581 participants. Studies focused on living with foot or ankle disorders in rheumatoid arthritis (n = 18), osteoarthritis (n = 5), gout (n = 3), psoriatic arthritis (n = 1), lupus (n = 1), posterior tibial tendon dysfunction (n = 1), plantar heel pain (n = 1), Achilles tendonitis (n = 1), and mixed population (n = 3) patients. Six themes were generated from the thematic synthesis: pain, change in appearance, activity limitations, social isolation, limited work ability and emotional impact. Foot or ankle pain was the predominant symptom experienced by patients in all included studies and was closely linked to other themes. Both pain and change in appearance of the feet or ankles (deformity), and subsequent limitations in footwear and clothing choices, led to restrictions in physical activities, social participation and work. Emotional distress, including anxiety, anger and embarrassment, was common among patients with foot and ankle disorders across all of the RMDs explored in this review. Conclusion This is the first study to synthesise findings of qualitative research exploring the lived experience of patients with foot and ankle disorders in RMDs. Findings indicate that these disorders impact on multiple areas of patients’ lives, both physically and psychologically. Patients’ experiences of foot and ankle disorders are similar across different RMDs, although there are a limited number of qualitative studies focusing on conditions other than rheumatoid arthritis. These findings will inform a future consensus study prioritising the outcomes that should be measured in future research studies and clinical practice. Disclosure L.S. Chapman: None. C. Flurey: None. A.C. Redmond: None. P. Richards: None. C. Hofstetter: None. B. Tapster: None. J. Emmel: None. P.S. Helliwell: None. H.B. Menz: None. M.T. Hannan: None. B. Shea: None. H.J. Siddle: None.

Background Foot pain is common and disabling in older adults however little is known about its course. The objective of this study was to identify foot pain trajectories over seven years and examine the associations between progressive symptom trajectories and potential prognostic factors. Methods All adults aged ≥50 years registered with four general practices in North Staffordshire, UK were mailed a health survey at baseline. Those reporting foot pain in the previous 12 months were invited to attend a research clinic that included a standardised interview, physical examination, and plain radiographs of the feet. Follow-up was by repeated postal surveys at 18 months, three years, 54 months, and seven years. Trajectories of repeated measures of foot pain severity in the previous month (10-point numerical rating scale) were identified using Latent Class Growth Analysis (LCGA). Logistic regression was undertaken to explore the relationship between these trajectories and both person-level and foot-level prognostic factors adjusted for covariates (age, gender, and body mass index). Results Of 560 adults with foot pain attending baseline research clinics, 425 (76%) provided data at baseline and ≥two follow-up time-points and were included in the analysis. The optimum LGCA model for foot pain severity was a 4-class model with the following trajectories: mild improving pain (n = 109, 26%); moderate improving pain (n = 179, 42%); moderate persistent pain (n = 122, 29%); severe persistent pain (n = 15, 4%). Compared with individuals with mild/moderate improving pain trajectories, those with moderate/severe persistent pain trajectories over 7 years did not differ significantly by age, sex, foot posture or radiographic foot OA phenotype at baseline, but were more likely to be overweight/obese. After adjustment for covariates, these less favourable long-term trajectories were associated with lower socioeconomic position, poorer physical and mental health, catastrophising, greater foot-specific functional limitation (Manchester Foot Pain and Disability Index), and self-reported hallux valgus at baseline (Table 1). Conclusion Over a 7-year period, one-third of individuals had persistent moderate to severe pain. Targeting interventions to modifiable prognostic factors such as obesity and hallux valgus may have the potential to improve long-term outcomes in people with foot pain. Disclosures M. Marshall None. M. Blagojevic-Bucknall None. T. Rathod-Mistry None. M.J. Thomas None. J.J. Edwards Other; JJE is part of The Keele Academic General Practice which has received funding from Bristol-Myers Squibb to develop and evaluate a quality improvement tool in anticoagulation. G. Peat None. H.B. Menz None. E. Roddy None.

Objectives\ud To examine associations between plantar calcaneal spurs, plantar fascia thickening and plantar heel pain (PHP), and to determine whether tenderness on palpation of the heel differentiates between these presentations. \ud \ud Methods\ud Adults aged ≥50 years registered with four general practices were mailed a Health Survey. Responders reporting foot pain within the last 12 months underwent a detailed clinical assessment. PHP in the past month was documented using a foot manikin. Plantar calcaneal spurs were identified from weight-bearing lateral radiographs and plantar fascia thickening (defined as >4mm) from ultrasound. Tenderness on palpation of the plantar fascia insertion was documented. Associations between these factors and PHP were explored using generalised estimating equations.\ud \ud Results\ud Clinical and radiographic data were available from 530 participants (296 women, mean [SD] age 64.9 [8.4] years), 117 (22.1%) of whom reported PHP. Plantar calcaneal spurs and plantar fascia thickening were identified in 281 (26.5%) and 501 (47.3%) feet, respectively, but frequently coexisted (n=217, 20.4%). Isolated plantar calcaneal spurs were rare (n=64, 6.0%). Participants with PHP were more likely to have a combination of these features compared to those without PHP (odds ratio 2.16, 95% confidence interval 1.24–3.77, p=0.007). Tenderness on palpation of the heel was not associated with plantar calcaneal spurs or plantar fascia thickening, either in isolation or in combination, in those with PHP. \ud \ud Conclusion\ud Plantar calcaneal spurs and plantar fascial thickening are associated with PHP, but frequently coexist. Tenderness on palpation of the heel does not appear to differentiate between clinical presentations of PHP.

Objectives. Foot orthoses are commonly used in the management of knee OA, although the relationship between foot function and knee OA is still unclear. The purpose of the study was to examine foot function during walking in people with and without medial compartment knee OA. Methods. Motion of the tibia, rearfoot and forefoot in 32 patients with medial compartment knee OA and 28 age-matched control subjects was investigated. Multivariate analysis was used to compare the groups. Results. The knee OA group contacted the ground with a more everted rearfoot, demonstrated greater peak rearfoot eversion and exhibited reduced rearfoot frontal plane range of motion and reduced rearfoot peak inversion. The tibia was more internally rotated and laterally tilted throughout the gait cycle, with reduced peak external rotation. Conclusion. People with medial compartment knee OA exhibit altered foot kinematics during gait that are indicative of a less mobile, more everted foot type. The presence and degree of tibial malalignment and the available rearfoot range of motion during walking may affect individual responses to load-altering interventions, such as foot orthoses and footwear modifications. Trial registration: Australian New Zealand Clinical Trials Registry, www.anzctr.org.au/, ACTRN

productivity loss measures and the correlation between these 5 measures were moderate. The latter probably reflecting differences in concepts, recall periods, and references used in these measures. The moderate association between the global at-work productivity measures and VAS general well-being suggests that the impact of arthritis on work is only partly captured by generic health measures. Disclosure statement: The authors have declared no conflicts of interest.