الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus (DM) is a chronic metabolic disease of high
morbidity and mortality. The prevalence of type 2 DM are increases more
than that of type 1 DM because of the increase in obesity and the
reduction in physical activities as countries become more industrialized.
Most published studies reported that capsulitis and tendonitis in the
shoulder are the most common conditions, whereas carpal tunnel
syndrome (CTS), Dupuytren’s contracture and trigger finger are the
commonest abnormalities of the hand observed in the diabetic patients.
Musculoskeletal ultrasound (US) is an imaging tool with a wide set of
advantages over other imaging modalities, being safe, easily accessible,
relatively cheap, not invasive and lacking of any contraindications.
The aim of our study was to evaluate the hand musculoskeletal
disorders found in diabetic patients and their correlation with disease
duration, severity and control of DM by using the relatively new method
(ultrasound).
The mean age of diabetic patients in our study was slightly older
than control subjects (49.6 years versus 47.4 years). 80% of our
participants were females, and also 80% of the cases were housewives,
with non significant difference. The majority of our cases and controls
were from rural areas (80%). Regarding smoking, only five diabetic cases
were smokers (8.3%) versus one of the controls (5%). The majority of our
cases and controls were married, all these showed non significant
differences. On the other hand, family history of DM was positive in 38%
of our cases, compared to only 15% among the control subjects, with
Summary and Conclusion 111
significant difference. The disease duration of our study cases varied
greatly, from 1-15 years, with a mean of 7 years, which is reflected by the
wide standard deviation (3.7 years). Regarding treatment, two thirds of
the cases treated by oral drugs (39 cases, 65%) and only 21 cases (35%)
treated by insulin. Age at diagnosis of DM ranged from 27-63 years, with
a mean of 42.5±7.9 years. The general signs and symptoms did not show
significant difference between cases and controls. The only exceptions
were Phalen’s test, Tinel’s sign and VAS, which were significantly higher
among cases compared to controls.
As expected, we found that the mean fasting blood sugar (FBS),
random blood sugar (RBS) and HbA1C was significantly higher among
DM cases, compared to controls. Also, serum uric acid, was higher
among cases, with significant difference.
Diabetic cases in our study showed higher synovitis scores by BM
mode, both dorsal and palmar sides; more erosions (only from dorsal
view), osteophytes (both palmar and dorsal) and more tenosynovitis; all
with significant to highly significant differences on the right hand and left
hand. Cross sectional area of the median nerve (CSA) and the depth of
the carpal tunnel (DCT) were significantly higher among DM cases
compared to controls, all of the US scores of the hands were worse
among DM cases compared to controls.
Conclusion
Muscoloskeletal ultrasound is a good and non invasive technique
that can be used for early detection of the hands in diabetic patients,
which are greatly under-estimated by most clilnicians.