Published 20-09-2021
Keywords
- Diabetes mellitus,
- Enthesitis,
- lower extremity entheseal sites,
- retrocalcaneal bursitis,
- Glasgow Ultrasound Enthesitis Scoring System (GUESS)
- Non-alcoholic fatty liver disease ...More
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Abstract
Background: Diabetes mellitus is a leading cause of death and disability worldwide. Its global prevalence was about 8% in 2011 and is predicted to rise to 10% by 2030. DM has great impact on the connective tissue and prolongation of diabetes period increases the degree of complications. Musculoskeletal ultrasonography using the Glasgow Ultrasound Enthesitis Scoring System (GUESS) is a validated and useful tool to quantify articular and periarticular changes of lower extremity. Objectives: The objective of this study is to findout the correlation between Glasgow Ultrasound Enthesitis Score in diabetic patients and duration of DM.
Materials and Methods: This Cross sectional study was carried out in the Department of Radiology and Imaging, BIRDEM, Dhaka, during July 2017 to June 2019 period. For this purpose, a total of 120 diabetic patients were included in this study. Observation and Results: Results revealed the mean age (±SD) was 49.46±7.99 years ranging from 35-64 years. Male to female ratio was 1:1.1. There was positive significant correlation found between duration of DM with the suprapatellar bursitis (r=0.637; p=0.001), infrapatellar bursitis (r=0.319; p=0.001) retrocalcaneal bursitis(r=0.715;p=0.001), quadriceps tendon thickness (r=0.583;p=0.001), proximal patellar ligament thickness(r=0.441;p=0.001) and Achilles tendon thickness (r=0.343;p=0.001). On the other hand, there was a negative correlation (r=-0.176; p=0.055) was found between the plantar aponeurosis thickness with duration of DM. There was a significant positive correlation (r=0.941; p=0.001) was found between the total GUESS score with duration of DM. There was also a positive correlation was found between duration of diabetes with total enthesophyte score (r=0.734; p=0.001) and total erosion score (r=0.791; p=0.001). The receiveroperator characteristic (ROC) curves of duration of DM had area under curve 0.988; 95% confidence interval, 0.974–1.00, with a cut off value 20 years having 57.6% sensitivity and 100.0% specificity for prediction of severe entheseal damage. Conclusion: This study indicates that Ultrasonographic evaluation of lower extremity entheseal sites in diabetic patient by using Glasgow Ultrasound Enthesitis Scoring System (GUESS) significantly correlated with duration of diabetes.
References
- American Diabetes Association. Diagnosis and classification of diabetes mellitus. 2008. Diabetes Care. 31, pp.55-60.
- International Diabetes Federation (IDF) [Internet]. Country estimates table 2011. IDF diabetes atlas. 6th ed. 2012. Available
- from:
- Papanas, N., Courcoutsakis, N., Papatheodorou, K., Daskalogiannakis, G., Maltezos, E. & Prassopoulos, P., 2009. Achilles tendon volume in type 2 diabetic patients with or without peripheral neuropathy: MRI study. Experimental and
- clinical endocrinology & diabetes. 117(10), pp.645-648.
- Aydeniz, A., Gursoy, S. & Guney, E., 2008. Which musculoskeletal complications are most frequently seen in type 2 diabetes
- mellitus? Journal of International Medical Research. 36(3), pp.505-511.
- Balint, P.V. & Sturrock, R.D., 2001. Intraobserver repeatability and interobserver reproducibility in
- musculoskeletal ultrasound imaging measurements. Clinical and experimental rheumatology. 19(1), pp.89-92.
- Abate, M., Schiavone, C. & Salini, V., 2010. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with
- diabetes. BMC Musculoskeletal Disorders. 11(1), p.278.
- Okur, S.C., Dogan, Y.P., Mert, M., Aksu, O., Burnaz, O. & Caglar, N.S., 2017. Ultrasonographic Evaluation of Lower
- Extremity Entheseal Sites in Diabetic Patients Using Glasgow Ultrasound Enthesitis Scoring System Score. Journal of medical ultrasound. 25(3), pp.150-156.
- Kerimoglu, U., Hayran, M., Ergen, F.B., Kirkpantur, A. & Turgan, C., 2007. Sonographic evaluation of entheseal sites of the lower extremity in patients undergoing hemodialysis. Journal of Clinical Ultrasound. 35(8), pp.417-423.
- Batista, F., Nery, C., Pinzur, M., Monteiro, A.C., de Souza, E.F., Felippe, F.H., Alcântara, M.C.& Campos, R.S., 2008. Achilles tendinopathy in diabetes mellitus. Foot Ankle Int. 29(1), pp-498-501.
- Abate, M., Di Carlo, L., Salini, V. & Schiavone, C., 2014. Metabolic syndrome associated to non-inflammatory Achilles
- enthesopathy. Clinical rheumatology. 33(10), pp.1517-1522.
- Unlu, Z., Ozmen, B., Tarhan, S., Boyvoda, S. & Goktan, C., 2003. Ultrasonographic evaluation of pes anserinus tendinobursitis in patients with type 2 diabetes mellitus. The Journal of rheumatology. 30(2), pp.352-354.
- Wyatt, L.H. & Ferrance, R.J., 2006. The musculoskeletal effects of diabetes mellitus. The Journal of the Canadian Chiropractic Association. 50(1), pp.43-50.
- Battery, L. & Maffulli, N., 2011. Inflammation in overuse tendon injuries. Sports medicine and arthroscopy review. 19(3), pp.213-217
- De Oliveira, R.R., Lemos, A., de Castro Silveira, P.V., Da Silva, R.J. & De Moraes, S.R.A., 2011. Alterations of tendons in patients with diabetes mellitus: a systematic review. Diabetic Medicine. 28(8), pp.886-895.
- Serban, O., Porojan, M., Deac, M., Cozma, F., Solomon, C., Lehghel, M., Micu, M. & Fodor, D., 2016. Pain in bilateral knee
- osteoarthritis–correlations between clinical examination, radiological, and ultrasonographical findings. Medical ultrasonography. 18(3), pp.318-325.
