Buldt AK, Munteanu SE, Allan JJ, et al. - This research was performed to ascertain if foot structure varies according to the presence and radiographic severity of first metatarsophalangeal joint osteoarthritis (first MTPJ OA). Researchers collected weight‐bearing dorso‐plantar and lateral radiographs for the symptomatic foot of 185 participants (105 females, aged 22 to 85 years) with clinically diagnosed first MTPJ OA. They applied a validated atlas categorize participants as having radiographic first MTPJ OA and to stratified into three categories of severity (none/mild, moderate, severe). They conducted bone length, width and angular measures of the forefoot and medial arch on radiographs, and variations between categories were correlated applying univariate general linear models, adjusting for confounders. The data exhibt that first ray alignment and morphology differ according to the presence and severity of first MTPJ OA. Prospective studies are needed to ascertain if the observed differences are a cause or consequence of OA.