MRI assessment of regional differences in phosphorus‐31 metabolism and morphological abnormalities of the foot muscles in diabetes

Abstract

Changes in atrophy and metabolism appear to occur unequally between different regions of the forefoot in diabetes. The adductor hallucis region appears more capable of maintaining structural and metabolic integrity than the flexor hallucis or interosseous regions. The CV analysis suggests that the quantitative P methods have less variability than the qualitative grading. J. Magn. Reson. Imaging 2016;44:1132-1142.

New insights into intrinsic foot muscle morphology and composition using ultra-high-field (7-Tesla) magnetic resonance imaging.

“…Alternatively, muscle volumes could be reported for muscle groups (e.g. abductor hallucis together with exor hallucis brevis, abductor digiti minimi together with exor digiti minimi) [16,32], or the intrinsic foot muscles as a whole [7,8,13,14,[17][18][19]26], similar to that reported by previous studies.…”

“…In this report of a new method, we follow suggestions from the earlier papers in this series [34,35] towards quanti cation of muscle fat in ltration for individual intrinsic foot muscles. Using semi-quantitative methods, previous MRI studies at the foot have reported low fatty in ltration in healthy participants [11,16,20]. One study that used a quantitative method [13,14], reported that 22.7% of total intrinsic foot muscle volume was intramuscular adipose tissue (muscle fat in ltration) in 12 healthy adults (mean age 57 years).…”

“…MRI of muscle of the foot has been used to evaluate intrinsic foot muscle morphology in several patient populations, such as individuals with diabetes [7][8][9][10][11][12][13][14][15][16][17], plantar heel pain [18,19], foot pain [20,21], Charcot-Marie-Tooth [22,23], and chronic ankle instability [24,25], as well as to evaluate the effect of interventions such as physical therapy [24], footwear [26,27] and foot exercise [28][29][30]. Table 1 provides a summary of published methods from studies that have evaluated intrinsic foot muscle morphology and composition.…”

<sup>31</sup>P MR Spectroscopy with 3D Chemical-Shift Imaging Detects Changes in Levels of Phosphorus Metabolites Due to Saliva Secretion in Human Parotid Glands

“…MRS can be used to identify information such as the type of metabolite, its concentration, and the relaxation time. Phosphorus magnetic resonance spectroscopy ( 31 P-MRS) is a non-invasive technique that provides useful information regarding the metabolic and phosphoenergetic status of human tissue, in both physiological and pathological conditions [2] [3]. In addition to the information contained within static spectra, dynamic 31 P-MRS has been used to assess changes in the levels of phosphorus metabolites…”

Hip joint torques in type II diabetes with and without neuropathy

“…Progressive muscle weakness is usually considered as the most important musculoskeletal complications of the diabetes which mainly causes the disability [3]. It seems that 30–47% of patients with type II diabetes experience musculoskeletal complications in their life time [4]. Upper and lower weakness is evident in patients with long-term diabetes and there is a controversy that if lower extremity is more affected than upper extremity [3].…”