The Value of Muscle Thickness of Lower Limbs in Detection of Diabetic Peripheral Neuropathy

Sally H. Abdulkareem; Abdulnasir  H. Ameer

doi:10.32007/jfacmedbagdad.2130

Authors

Sally H. Abdulkareem Baghdad medical college https://orcid.org/0009-0009-5919-1503
Abdulnasir H. Ameer Dept. of Physiology, College of Medicine, University of Baghdad

DOI:

https://doi.org/10.32007/jfacmedbagdad.2130

Keywords:

Neuromuscular Ultrasound, Muscle Thickness, Diabetic Peripheral Neuropathy

Abstract

Background: Neuropathy stands out as the highest-prevalence diabetes-related complication, impacting no less than 50% of individuals with diabetes throughout their lifespan. As The most common reason for disability due to walking difficulties, foot ulcerations, and limb loss, DPN is worthy of study, and early diagnosis of DPN signs is required.

Objectives: This study aims to aid in the identification of diabetic peripheral neuropathy (DPN) by determining the muscle thickness of the lower extremities in patients with DPN.

Patients and Methods: The study included 24 subjects with diabetic peripheral neuropathy (DPN) and 25 individuals as a control group, subdivided into 8 diabetic patients without DPN and 17 healthy individuals. Both control and DPN subjects underwent bilateral peroneal and tibial motor nerve conduction studies (NCS) and high-resolution muscle ultrasounds to measure muscle thickness. Abductor hallucis muscle (AH), extensor digitorum brevis muscle (EDB), extensor hallucis longus muscle (EHL), tibialis anterior muscle (TA), and rectus femoris muscle (RF) were evaluated on both sides using ultrasound.

Results: Comparing the tested muscles to the control group, the study revealed a statistically significant decrease in the thickness of many of the muscles being tested when compared to the control group.

Conclusions: These findings point to the possibility that quantitative muscle ultrasound could be beneficial in identifying muscle changes associated with DPN. It is necessary to conduct additional studies to verify the results in larger samples of diabetic patients.

Keywords: Neuromuscular Ultrasound, Muscle Thickness, Diabetic Peripheral Neuropathy

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References

Noaman AA. Assessment of Preventive Foot Care Practices among Patients with Diabetes Mellitus Type II. J Fac Med Baghdad [Internet]. 2017 Oct 1 [cited 2023 Apr 23];59(3):244–8. Available from: https://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/97

Abed BA. The Relationship between Family History and C-peptide Level in Type2 Diabetic Patients. J Fac Med Baghdad [Internet]. 2013 Jul 1 [cited 2023 Apr 23];55(3):258–64. Available from: https://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/627

BASHAR KATERJI. BASHAR KATERJI:Bradley’s Neurology in clinical practice,7th edition,107:1791-1866.e12. 2016.

Jaid HK, Khaleel FM, Salman IN, Abd BA. Estimation of Apelin Levels in Iraqi Patients with Type II Diabetic Peripheral Neuropathy. Baghdad Science Journal [Internet]. 2023 Feb 20 [cited 2023 May 3]; Available from: https://bsj.uobaghdad.edu.iq/index.php/BSJ/article/view/7566

Al-Deen ZMM, Ajeena IA. Study of Advanced Glycation End Products in Patients with Diabetic Neuropathy. Medical Journal of Babylon [Internet]. 2015 [cited 2023 May 4];12(1). Available from: https://www.iasj.net/iasj/article/101000

Patel K, Horak H, Tiryaki E. Diabetic neuropathies. Muscle Nerve [Internet]. 2021 Jan 1 [cited 2022 Oct 23];63(1):22–30. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/mus.27014

Uzuner B, Ketenci S, Salbaş E. Diyabetik nöropatiye genel yaklaşım. Acta Medica Alanya [Internet]. 2020 Sep 7 [cited 2022 Nov 20]; Available from: http://acikerisim.alanya.edu.tr/xmlui/handle/20.500.12868/1300

Rubin DI. Technical issues and potential complications of nerve conduction studies and needle electromyography. Neurol Clin [Internet]. 2012 May 1 [cited 2023 Apr 2];30(2):685–710. Available from: http://www.neurologic.theclinics.com/article/S0733861911001381/fulltext

Gellhorn AC, Carlson MJ. Inter-Rater, Intra-Rater, and Inter-Machine Reliability of Quantitative Ultrasound Measurements of the Patellar Tendon. Ultrasound Med Biol. 2013 May 1;39(5):791–6.

Maurits NM, Bollen AE, Windhausen A, De Jager AEJ, Van Der Hoeven JH. Muscle ultrasound analysis: normal values and differentiation between myopathies and neuropathies. Ultrasound Med Biol. 2003 Feb 1;29(2):215–25.

Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve [Internet]. 2011 Oct [cited 2023 Apr 2];44(4):597–607. Available from: https://pubmed.ncbi.nlm.nih.gov/21922474/

El Hefnawy HE, Howayda ;, Zidan F, Soad ;, El Mola S, Gamil AM, et al. Correlation between Quantitative Ultrasonography on Small Muscles of the Foot in Diabetic Peripheral Neuropathy and Electrodiagnostic Study [Internet]. Vol. 88, Cairo Univ. 2020. Available from: www.medicaljournalofcairouniversity.net

Abraham A, Drory VE, Fainmesser Y, Algom AA, Lovblom LE, Bril V. Muscle thickness measured by ultrasound is reduced in neuromuscular disorders and correlates with clinical and electrophysiological findings. Muscle Nerve [Internet]. 2019 Dec 1 [cited 2023 Apr 27];60(6):687–92. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/mus.26693

Severinsen K, Obel A, Jakobsen J, Andersen H. Atrophy of Foot Muscles in Diabetic Patients Can Be Detected With Ultrasonography. Diabetes Care [Internet]. 2007 Dec 1 [cited 2023 Apr 27];30(12):3053–7. Available from: https://diabetesjournals.org/care/article/30/12/3053/28134/Atrophy-of-Foot-Muscles-in-Diabetic-Patients-Can

Kadhim ZM, Alkhafaji MM. Zahid M. Kadhim et al / The Role of Muscle Thickness and Echogenicity in the Diagnosis of Diabetic Peripheral Neuropathy The Role of Muscle Thickness and Echogenicity in the Diagnosis of Diabetic Peripheral Neuropathy. NeuroQuantology [Internet]. 2021 [cited 2023 Apr 25];19(8):113–8. Available from: www.neuroquantology.com