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Atrophy of foot muscles in diabetic patients can be detected with ultrasonography.

Neurology* Aarhus University Hospital, DENMARK
Neuroradiology**, Aarhus University Hospital, DENMARK

hande{at}as.aaa.dk

ABSTRACT

Objective: To establish a bedside test with ultrasonography for evaluation of foot muscle atrophy in diabetic patients.

Research Design and Methods: Thickness and cross sectional area of the extensor digitorum brevis muscle (EDB) and of the muscles of the first interstitium (MIL) were determined in 26 diabetic patients and in 26 matched control subjects using ultrasonography. To estimate the validity findings were related to the total volume of all foot muscles determined at magnetic resonance imaging (MRI-FM_vol). Furthermore, the relations of ultrasonographic estimates to nerve conduction, sensory perception tresholds and clinical condition were established.

Results: In diabetic patients the ultrasonographic thickness of EDB (U-EDB_t) was 6.4 ± 2.1 mm (mean ± SD) vs. 9.0 ± 1.0 mm in controls (p<0.001), thickness of MIL (U-MIL_t) was 29.6 ± 8.3 mm vs. 40.2 ± 3.6 mm in controls (p<0.001) and the cross sectional area of EDB (U-EDB_CSA) was 116 ± 65 mm² vs. 214 ± 38 mm² in controls (p<0.001). The MRI-FM_vol was directly related to U-EDB_t (r=0.77), U-MIL_t (r=0.71) and to U-EDB_CSA (r=0.74). U-EDB_t and U-MIL_t were thinner in neuropathic than in non-neuropathic diabetic patients (5.8 ± 2.1 mm vs. 7.5 ± 1.7 mm (p<0.05) and 28.3 ± 8.8 mm vs. 35.6 ± 4.3 mm (p<0.03), respectively).

Conclusions: Atrophy of intrinsic foot muscles determined at ultrasonography is directly related to foot muscle volume determined by MRI and to various measures of diabetic neuropathy. Ultrasonography seems to be useful for detection of foot muscle atrophy in diabetes.

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