Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes

Abstract

BackgroundThe prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus.MethodsThe study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively), who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans.ResultsTendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p < 0.001; Biceps Tendon: 4 ± 0.8 mm vs 3.2 ± 0.4 mm, p < 0.001). Sonographic appearances of degenerative features in the rotator cuff and biceps were more frequently observed in diabetics (Supraspinatus Tendon: 42.7% vs 20.3%, p < 0.003; Biceps Tendon: 27% vs 7.8%, p < 0.002).Subjects with diabetes exhibited more tears in the Supraspinatus Tendon (Minor tears: 15 (15.8%) vs 2 (3.1%), p < 0.03; Major tears: 15 (15.8%) vs 5 (7.8%), p = ns), but not in the long head of Biceps. More effusions in subacromial bursa were observed in diabetics (23.9% vs 10.9%, p < 0.03) as well as tenosynovitis in biceps tendon (33.3% vs 10.9%, p < 0.001).In both groups, pathological findings were prevalent on the dominant side, but no difference related to duration of diabetes was found.ConclusionsOur results suggest that age - related rotator cuff tendon degenerative changes are more common in diabetics.Ultrasound is an useful tool for discovering in pre - symptomatic stages the subjects that may undergo shoulder symptomatic pathologies.

Diabetes and shoulder disorders

“…Our findings confirmed that patients with diabetes, regardless of insulin use, had a higher risk of developing rotator cuff diseases. Our findings are in accord with previous imaging studies showing that degenerative changes of rotator cuff tendon were more commonly observed by sonography in patients with diabetes than in controls3.…”

Prevalence of and risk factors for asymptomatic rotator cuff tears in postmenopausal women

“…3 Tears were divided into small, large, or massive when the distance between the ends was less than 1 cm, more than 1 cm but less than 3 cm, and more than 3 cm, respectively.…”

“…3 For the purposes of the present study, analysis was restricted to the supraspinatus and infraspinatus tendons, and only full-thickness tears (FTTs) were taken into account.…”

The Clinical and Sonographic Effects of Kinesiotaping and Exercise in Comparison With Manual Therapy and Exercise for Patients With Subacromial Impingement Syndrome: A Preliminary Trial

“…Thus, the measurement of supraspinatus tendon thickness was found reliable. [16][17][18] The ultrasonographic diagnosis has the potential for becoming a valuable aid to the clinician in allowing confident diagnosis, and it enables to follow up treatment efficiency. [19][20][21][22] Rehabilitation of the patients with SIS is a complex process that requires a comprehensive evaluation and multifactorial treatment program.…”