Popis: |
BackgroundDiabetic cheiroarthropathies consist of limited joint mobility (LJM), flexor tenosynovitis (FTS), Dupuytren’s contracture (DC), and carpal tunnel syndrome (CTS). There is heterogeneity in definitions and lack of a method to measure hand fibrosis load. We measured metacarpophalangeal (MCP) joint restriction and describe magnetic resonance (MR) imaging characteristics across the spectrum of joint restriction.MethodsAdults with type 1 diabetes were screened for hand manifestations using a symptom questionnaire, clinical examination, function (Duruoz hand index (DHI), grip strength). We measured maximum possible extension at the MCP joint. Patients were segregated by mean MCP extension (60 degrees) for MRI scanning. Patients in the four groups were compared using ANOVA for clinical features as well as MRI measurements (tenosynovial, skin, and fascia thickness, additive score of three).FindingsOf 237 patients (90 males), 79 (33.8%) had cheiroarthropathy; these had MCP extension limitation (39 degrees versus 61 degrees, pInterpretationJoint mobility limitation, quantified by restricted MCP extension, was driven by skin thickening. MCP extension and fibrosis scoring on MRI can serve as quantitative measures of hand involvement for future associative studies. |