Diabetes: a silent player in musculoskeletal interventional radiology response
Autor: | Sofia Dimitri-Pinheiro, Raquel Soares, Apostolos H. Karantanas, Helena Torrão, Beatriz Cardoso-Marinho, Madalena Pimenta |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
collagen
Blood sugar Inflammation Review Article Bioinformatics General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Fibrosis Diabetes mellitus Medicine 030212 general & internal medicine Efferocytosis medicine.diagnostic_test business.industry ultrasound adhesive capsulitis/shoulder Interventional radiology medicine.disease Capsulitis trigger finger Trigger finger diabetes/complications medicine.symptom business 030217 neurology & neurosurgery hydrodistension |
Zdroj: | Porto Biomedical Journal |
ISSN: | 2444-8672 2444-8664 |
Popis: | Diabetes has an important role in the development of several musculoskeletal disorders, such as adhesive capsulitis of the shoulder (ACs) and stenosing flexor tenosynovitis of the finger (SfTf). The etiopathophysiology of ACs and SfTf in diabetic patients is associated with both chronic hyperglycemia, increased amounts of visceral adiposity and chronic inflammation. Chronic hyperglycemia stimulates the creation of cross-links between collagen molecules, impairing degradation and resulting in the build-up of excessive collagen deposits in the cartilage, ligaments, tendon sheaths and tendons. Increased adipocytes in diabetic patients secrete proteins and cytocines such as TNF-α, IL-6 and IL-13 which result in overproduction of pro-inflammatory factors, destruction of normal tissue architecture and fibrosis. Both hyperglycemia and adipocytes inhibit efferocytosis, limiting natural resolution. Recently, multiple image-guided interventional radiology musculoskeletal treatment options have been developed, such as ultrasound-guided glenohumeral capsule hydrodistension for ACs and ultrasound-guided percutaneous pulley release for trigger finger. Diabetes can negatively influence outcomes in patients with ACs and SfTf and may impact the decision of which specific procedure technique should be employed. Further studies are necessary to define how diabetes influences response to interventional radiology treatments of these disorders, as well as the extent to which control of blood sugar levels can contribute towards the personalization and optimization of patient follow up. |
Databáze: | OpenAIRE |
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