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.

High prevalence of achilles tendon enthesopathic changes in patients with type 2 diabetes without peripheral neuropathy

Ursini F.;Olivieri I.;
2017

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 =.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.
Ursini F.; Arturi F.; D'Angelo S.; Amara L.; Nicolosi K.; Russo E.; Naty S.; Bruno C.; De Sarro G.; Olivieri I.; Grembiale R.D.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/781911
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