Seok Kang1, Se Hwa Kim1, Seung Nam Yang1, Joon Shik Yoon2. 1. Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, Korea. 2. Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, Korea. Electronic address: rehab46@korea.ac.kr.
Abstract
OBJECTIVE: Diabetic polyneuropathy (DPN) is one of the major complications of diabetes mellitus. Ultrasound has been frequently used for evaluation of peripheral nerves. However, there are few studies that have evaluated multiple peripheral nerves in DPN. In this study, ultrasonographic features of multiple peripheral nerves in upper and lower extremities of DPN patients were investigated and compared with those of healthy controls. METHODS: This study was a case-control study that enrolled 20 patients with confirmed diagnosis of DPN and 20 healthy controls. The ultrasonography was performed on the sural, tibial, fibular, sciatic, median, ulnar, radial, and musculocutaneous nerves. Nerve cross-sectional area (CSA) was measured at multiple points for each peripheral nerve. The CSAs were compared between DPN and control groups, and analyzed in relation to the clinical characteristics and electrophysiologic findings. RESULTS: The CSAs were significantly larger in the DPN group for sural nerve, fibular nerve at the fibular head level, median nerve at the carpal tunnel and mid-humerus level, ulnar nerve at the cubital tunnel outlet and mid-humerus level, and radial nerve at the spiral groove. The CSAs of sural nerve, tibial nerve and median nerve were significantly correlated with electrophysiologic findings. The sural nerve CSA revealed significant correlation with HbA1c. CONCLUSIONS: These results suggest that the ultrasonography can provide useful information in diagnosis and evaluation of DPN.
OBJECTIVE:Diabetic polyneuropathy (DPN) is one of the major complications of diabetes mellitus. Ultrasound has been frequently used for evaluation of peripheral nerves. However, there are few studies that have evaluated multiple peripheral nerves in DPN. In this study, ultrasonographic features of multiple peripheral nerves in upper and lower extremities of DPN patients were investigated and compared with those of healthy controls. METHODS: This study was a case-control study that enrolled 20 patients with confirmed diagnosis of DPN and 20 healthy controls. The ultrasonography was performed on the sural, tibial, fibular, sciatic, median, ulnar, radial, and musculocutaneous nerves. Nerve cross-sectional area (CSA) was measured at multiple points for each peripheral nerve. The CSAs were compared between DPN and control groups, and analyzed in relation to the clinical characteristics and electrophysiologic findings. RESULTS: The CSAs were significantly larger in the DPN group for sural nerve, fibular nerve at the fibular head level, median nerve at the carpal tunnel and mid-humerus level, ulnar nerve at the cubital tunnel outlet and mid-humerus level, and radial nerve at the spiral groove. The CSAs of sural nerve, tibial nerve and median nerve were significantly correlated with electrophysiologic findings. The sural nerve CSA revealed significant correlation with HbA1c. CONCLUSIONS: These results suggest that the ultrasonography can provide useful information in diagnosis and evaluation of DPN.