We were pleased to learn of the interest in our editorial (1) by Dr. Roddy and his colleagues. In their letter in response to our commentary, they expressed concern about our use of a reference to the Clinical Assessment Study of the Foot (CASF) in a sentence about limitations of using a general foot pain question when defining symptomatic foot osteoarthritis (OA). We understood that the definition used in CASF of symptomatic radiographic foot OA was of radiographic OA and pain in the same joint site, and we recognize that this was an important improvement in efforts to define symptomatic foot OA. We acknowledge that the wording in our paper may not adequately convey our intended message.