Background: Metabolic disorders are known to alter the mechanical properties of tendons. We sought to evaluate the prevalence of asymptomatic Achilles tendon enthesopathic changes in patients with type 2 diabetes mellitus (T2DM) without peripheral neuropathy. Methods: We recruited 43 patients with T2DM and 40 controls. Neuropathy was excluded with the Michigan Neuropathy Scoring Instrument. Bilateral ultrasonography of the Achilles tendon enthesis was performed. Results: Patients with T2DM had a higher prevalence of hypoechogenicity (26.7% versus 2.5%; P = .0001), entheseal thickening (24.4% versus 8.7%; P = .007), and enthesophytes (74.4% versus 57.5%; P = .02). No differences were found in the number of patients with erosions (1.2% versus 0%; P > .99), cortical irregularities (11.6% versus 3.7%; P = .09), bursitis (5.8% versus 3.7%; P = .72), or tears (2.3% versus 1.2%; P > .99). The mean +/- SD sum of abnormalities was higher in patients with T2DM (1.5 +/- 1.1 versus 0.7 +/- 0.6; P < .0001), as was the percentage of bilateral involvement (72.1% versus 45.0%; P = .01). Mean +/- SD thickness did not differ between patients and controls (4.4 +/- 1.1 mm versus 4.2 +/- 0.8 mm; P = .07). Conclusions: According to our data, there is an elevated prevalence of asymptomatic Achilles tendon enthesopathic changes in patients with T2DM independent of peripheral neuropathy.
Background: Metabolic disorders are known to alter the mechanical properties of tendons. We sought to evaluate the prevalence of asymptomatic Achilles tendon enthesopathic changes in patients with type 2 diabetes mellitus (T2DM) without peripheral neuropathy. Methods: We recruited 43 patients with T2DM and 40 controls. Neuropathy was excluded with the Michigan Neuropathy Scoring Instrument. Bilateral ultrasonography of the Achilles tendon enthesis was performed. Results: Patients with T2DM had a higher prevalence of hypoechogenicity (26.7% versus 2.5%; P 1⁄4 .0001), entheseal thickening (24.4% versus 8.7%; P 1⁄4 .007), and enthesophytes (74.4% versus 57.5%; P 1⁄4 .02). No differences were found in the number of patients with erosions (1.2% versus 0%; P . .99), cortical irregularities (11.6% versus 3.7%; P 1⁄4 .09), bursitis (5.8% versus 3.7%; P 1⁄4 .72), or tears (2.3% versus 1.2%; P . .99). The mean 6 SD sum of abnormalities was higher in patients with T2DM (1.5 6 1.1 versus 0.7 6 0.6; P , .0001), as was the percentage of bilateral involvement (72.1% versus 45.0%; P 1⁄4 .01). Mean 6 SD thickness did not differ between patients and controls (4.4 6 1.1 mm versus 4.2 6 0.8 mm; P 1⁄4 .07). Conclusions: According to our data, there is an elevated prevalence of asymptomatic Achilles tendon enthesopathic changes in patients with T2DM independent of peripheral neuropathy. (J Am Podiatr Med Assoc 107(2): 99-105, 2017)
High Prevalence of Achilles Tendon Enthesopathic Changes in Patients with Type 2 Diabetes Without Peripheral Neuropathy
Russo E;Arturi F;Grembiale R;De Sarro G
2017-01-01
Abstract
Background: Metabolic disorders are known to alter the mechanical properties of tendons. We sought to evaluate the prevalence of asymptomatic Achilles tendon enthesopathic changes in patients with type 2 diabetes mellitus (T2DM) without peripheral neuropathy. Methods: We recruited 43 patients with T2DM and 40 controls. Neuropathy was excluded with the Michigan Neuropathy Scoring Instrument. Bilateral ultrasonography of the Achilles tendon enthesis was performed. Results: Patients with T2DM had a higher prevalence of hypoechogenicity (26.7% versus 2.5%; P 1⁄4 .0001), entheseal thickening (24.4% versus 8.7%; P 1⁄4 .007), and enthesophytes (74.4% versus 57.5%; P 1⁄4 .02). No differences were found in the number of patients with erosions (1.2% versus 0%; P . .99), cortical irregularities (11.6% versus 3.7%; P 1⁄4 .09), bursitis (5.8% versus 3.7%; P 1⁄4 .72), or tears (2.3% versus 1.2%; P . .99). The mean 6 SD sum of abnormalities was higher in patients with T2DM (1.5 6 1.1 versus 0.7 6 0.6; P , .0001), as was the percentage of bilateral involvement (72.1% versus 45.0%; P 1⁄4 .01). Mean 6 SD thickness did not differ between patients and controls (4.4 6 1.1 mm versus 4.2 6 0.8 mm; P 1⁄4 .07). Conclusions: According to our data, there is an elevated prevalence of asymptomatic Achilles tendon enthesopathic changes in patients with T2DM independent of peripheral neuropathy. (J Am Podiatr Med Assoc 107(2): 99-105, 2017)I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
