Musculoskeletal complications in diabetes mellitus
- Lesley D Hordon, MD
Lesley D Hordon, MD
- Consultant in Rheumatology
- University of Leeds, United Kingdom
- Section Editors
- Ira N Targoff, MD
Ira N Targoff, MD
- Section Editor — Muscle Disease
- Professor of Medicine, Section of Rheumatology
- University of Oklahoma Health Sciences Center
- Jeremy M Shefner, MD, PhD
Jeremy M Shefner, MD, PhD
- Section Editor — Neuromuscular Disease
- Professor and Chair of Neurology, Barrow Neurological Institute
- Professor of Neurology, University of Arizona, Phoenix
- Clinical Professor of Neurology, Creighton University
A variety of musculoskeletal conditions have been associated with diabetes mellitus (table 1). These problems are important to recognize because they often respond to treatment, preventing pain and disability and improving quality of life. Specific arthropathies of the hand and shoulder are discussed in this review. The relationships of diabetes with osteoarthritis and gout are not so clear, and the data that bear on the association, or lack thereof, are also briefly mentioned.
Estimates of the prevalence of musculoskeletal problems in patients with diabetes mellitus vary depending upon the definitions used for the problems and the study population with diabetes, which can range from a primary care cohort to patients with severe diabetes in a specialized referral setting.
There are several other musculoskeletal complications of diabetes mellitus which are discussed separately. These include limited joint mobility, neuropathic arthropathy (eg, Charcot joint), bone disease, and diabetic muscle infarction. (See "Limited joint mobility in diabetes mellitus" and "Diabetic neuropathic arthropathy" and "Bone disease in diabetes mellitus" and "Diabetic muscle infarction".)
Hand abnormalities are common in diabetic patients, reflecting pathologic changes in the microvasculature, connective tissue, and peripheral nerves. One study, for example, evaluated 100 diabetic patients selected randomly in an outpatient clinic. Hand abnormalities were observed in 50 patients, and more than one abnormality was found in 26 . Furthermore, 25 of the 50 patients with hand syndromes were disabled to such an extent that surgery was recommended. Carpal tunnel syndrome, Dupuytren's contracture, flexor tenosynovitis, and limited joint mobility were each present in approximately 20 percent .
In a study of 200 patients with type 1 or type 2 diabetes and 100 controls, the prevalence of hand or shoulder disorders was higher in the diabetic patients than in controls and correlated with the duration, but not the type, of diabetes .
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- HAND ABNORMALITIES
- Carpal tunnel syndrome
- Limited joint mobility
- Flexor tenosynovitis
- Diabetic sclerodactyly
- Reflex sympathetic dystrophy
- SHOULDER PAIN
- DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS
- NEUROPATHIC ARTHROPATHY
- BONE DISEASE
- DIABETIC MUSCLE INFARCTION
- INFORMATION FOR PATIENTS