Neurologic and radiologic abnormalities of the foot in diabetic patients

摘要

The radiological lesions and neuropathic complications are common in Diabetes Mellitus (DM). Foot deformities may lead to abnormal pressure distribution and foot ulcers. The aims of this study are to examine neurological disorders of the lower extremity and the radiological deformities of the foot and to search if any correlation between neurologic disorders and radiological deformities exist in DM.Methods; 46 subjects (mean age 56.30 ?13.45 years, 35 women, 11 men) with type-II DM and 30 non-diabetic subjects (mean age 55.20 ?12.20 years, 22 women, 8 men) were included. Neurological examination for polyneuropathy and radiological evaluation for foot deformities was performed by the same physiatrist. For polyneuropathy, superficial and deep sensation, pain, thermal, touch, proprioception and vibration senses were examined at right (RE) and left (LE) lower extremities. Foot deformities were evaluated by X-rays.Results: Peripheral sensorial neuropathy was present in 80.4 of the diabetic patients. In order of frequency from the highest to lowest; hallux valgus, epin calcanei, pes planus, fracture, lisfranc dislocation (LD), osteoporosis (OP), pes cavus and arterial and tendon calcification were detected in radiological examination. All the subjects with lisfranc dislocation, fracture, pes cavus and arterial calcification had neuropathy as well.Conclusion: Lisfranc dislocation, pes cavus and fractures were lesser in frequency but they were bilateral and their relation with sensorial neuropathy was about 100, so they seemed to be more important in DM foot deformities. We think further studies with large number of subjects are necessary to show the existence of sensorial neuropathy and lisfranc dislocation, pes cavus and fracture association.