Diabetes Mellituslu Hastalarda Omuz Morfolojisinin Ultrasonografik Değerlendirmesi

Amaç: Omuz dejenerasyonu ve rotator cuff yırtıkları yaşla artmakta ve omuz ağrısının sık nedeni olmaktadır. Diyabet kas iskelet sisteminde en çok patolojiye neden olan endokrin bozukluktur. Biz çalışmamızda diyabetik hastalarda ve kontrol grubu olarak asemptomatik hastalarda omuz morfolojisini değerlendirmeyi amaçladık. Yöntemler: Çalışmaya omuz ağrısı olmayan 52 diyabetik hasta (62,4±9,6 yıl) ve 46 diyabetik olmayan hasta (66,2±7,8 yıl) dahil edildi. Ultrasonografik değerlendirme sağ omuza standart protokol kullanılarak yapıldı. İnceleme lineer prob (5-13 MHz) ile multiplanar olarak yapıldı. Bulgular: Diyabetik hastaların 8’inde (%17,4), kontrol grup hastaların ise 7’sinde (%13,5) kalsfik tendinit varlığı belirlendi. Diyabetik hastaların 4’ünde (%8,7), kontrol grup hastaların ise 1’inde (%1,9) supraspinatus tendonunda parsiyel yırtık belirlendi. Diyabetik hastaların 8’inde (%17,4), kontrol grup hastaların ise 2’sinde (%3,8) supraspinatus tendonunda tam kat yırtık belirlendi. Diyabetik hastaların 10’unda (%19,0), kontrol grup hastaların ise 6’sında (%13,0) biseps tendiniti belirlendi. Diyabetik ve kontrol grubu hastalar karşılaştırıldığında gruplar arasında kalsifik tendinit görülme sıklığı, supraspinatus tendonunda yırtık varlığı ve biseps tendinit görülme sıklığı açısından anlamlı fark gözlendi (p

Ultrasonographic Evaluation of Shoulder in Patients with Diabetes Mellitus

Objective: Shoulder degeneration and rotator cuff tears increase with age and become a frequent cause of shoulder pain. Diabetes mellitus (DM) is the most common endocrine disorder causing pathologies in the musculoskeletal system. In our study, we aimed to evaluate shoulder morphology in diabetic and control groups. Methods: Fifty two diabetic patients (62.4±9.6 years) and 46 non-diabetic patients (66.2±7.8 years) with no shoulder pain were included in the study. Ultrasonographic evaluation was performed on right shoulder using the standard protocol. The examination was performed multiplanar with a linear probe (5-13 MHz). Results: Calcific tendinitis was detected in 8 of diabetic patients (17.4%) and in 7 of control patients (13.5%). Partial tear was detected in supraspinatus tendon in 4 of diabetic patients (8.7%) and in 1 of control patients (1.9%). Full-thickness tears were found in supraspinatus tendon in 8 of diabetic patients (17.4%) and in 2 patients (3.8%). Biceps tendinitis was detected in 10 of diabetic patients (19.0%) and in 6 of control patients (13.0%). There was a significant difference between groups in terms of frequency of calcific tendinitis, presence of supraspinatus tendon tear, and frequency of biceps tendinitis (p

Kaynakça

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care Jan 2008;31:55-60.

Ardic F, Soyupek F, Kahraman Y, Yorgancioglu R. The musculoskeletal complications seen in type II diabetics: predominance of hand involvement. Clin Rheumatol 2003;22:229-33.

Egede LE. Diabetes, major depression, and functional disability among U.S. adults. Diabetes Care 2004;27:421-8.

Birch HL. Tendon matrix composition and turnover in relation to functional requirements. Int J Exp Pathol 2007;88:241-8.

Itoi E, Minagawa H, Yamamoto N, Seki N, Abe H. Are pain location and physical examinations useful in locating a tear site of the rotator cuff? Am J Sports Med 2006;34:256-64.

Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br 1995;77:296-8.

Moosmayer S, Smith HJ, Tariq R, Larmo A. Prevalence and characteristics of asymptomatic tears of the rotator cuff: an ultrasonographic and clinical study. J Bone Joint Surg Br 2009;91:196-200.

Needell SD, Zlatkin MB, Sher JS, Murphy BJ, Uribe JW. MR imaging of the rotator cuff: peritendinous and bone abnormalities in an asymptomatic population. AJR Am J Roentgenol 1996;166:863-7.

Papatheodorou A, Ellinas P, Takis F, Tsanis A, Maris I, Batakis N. US of the shoulder: rotator cuff and non-rotator cuff disorders. Radiographics 2006;26:e23.

Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJ. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Ann R Coll Surg Engl 2006;88:116- 21.

Abate M, Schiavone C, Salini V. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes. BMC Musculoskelet Disord 2010;11:278.

Namdari S, Baldwin K, Glaser D, Green A. Does obesity affect early outcome of rotator cuff repair? J Shoulder Elbow Surg 2010;19:1250-5.

Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease. Acomparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 2006;88:1699-704.

Fukuda H, Hamada K, Yamanaka K. Pathology and pathogenesis of bursal side rotator cuff tears viewed from en bloc histologic sections. Clin Orthop Relat Res 1990;254:75-80.

Goodmurphy CW, Osborn J, Akesson EJ, Johnson S, Stanescu V, Regan WD. An immunocytochemical analysis of torn rotator cuff tendon taken at the time of repair. J Shoulder Elbow Surg 2003;12:368-74.

Hegedus EJ, Cook C, Fiander C, Wright A. Measures of arch height and their relationship to pain and dysfunction in people with lower limb impairments. Physiother Res Int 2010;15:160-6.

Ishii H, Brunet JA, Welsh RP, Uhthoff HK. “Bursal reactions” in rotator cuff tearing, the impingement syndrome, and calcifying tendinitis. J Shoulder Elbow Surg 1997;6:131-6.

Rudzki JR, Adler RS, Warren RF, Kadrmas WR, Verma N, Pearle AD, Lyman S, Fealy S. Contrast-enhanced ultrasound characterization of the vascularity of the rotator cuff tendon: age- and activity-related changes in the intact asymptomatic rotator cuff. J Shoulder Elbow Surg 2008;17(Suppl 1):96S-100S.

De Groot J. The AGE of the matrix: chemistry, consequence and cure. Curr Opin Pharmacol 2004;4:301-5.

Dutta U, Cohenford MA, Guha M, Dain JA. Non-enzymatic interactions of glyoxylate with lysine, arginine, and glucosamine: a study of advanced non-enzymatic glycation like compounds. Bioorg Chem 2007;35:11-24.

Reiser KM. Nonenzymatic glycation of collagen in aging and diabetes. Proc Soc Exp Biol Med 1998;218:23-37

Ippolito E, Natali PG, Postacchini F, Accinni L, De Martino C. Morphological, immunochemical, and biochemical study of rabbit achilles tendon at various ages. J Bone Joint Surg Am 1980;62:583-98.

Kaynak Göster

  • ISSN: 2148-2373
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2013
  • Yayıncı: Galenos Yayınevi

3.7b 2.1b