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. 2021;20(83):e291-e299.
doi: 10.15557/JoU.2020.0051. Epub 2020 Dec 18.

Achilles tendon degeneration on ultrasound in type 2 diabetic patients

Babalola Ishamel Afolabi  1 , Bukunmi Michael Idowu  2 , Stephen Olaoluwa Onigbinde  3
Affiliations

Achilles tendon degeneration on ultrasound in type 2 diabetic patients

Babalola Ishamel Afolabi et al. J Ultrason. 2021.

Abstract

Aim of study: The main goal of this study was to compare the various degenerative changes in the Achilles tendon of type 2 diabetic patients to that of controls. The influence of diabetic peripheral neuropathy, duration of diabetes mellitus, age, and body mass index on the occurrence of degenerative changes was also evaluated.

Materials and methods: The Achilles tendons of both limbs were evaluated with high-resolution ultrasound in 80 type 2 diabetics and 80 age/sex-matched controls. A 10 g Semmes Weinstein monofilament was used to examine for peripheral neuropathy. Anthropometric measurements and biochemical assessment of glycemic control (fasting plasma glucose and glycated hemoglobin) were also done.

Results: The mean age of type 2 diabetic subjects and healthy controls was 60.9 ± 10.3 years (range 41-79 years) and 61.0 ± 10.3 years (range 40-79 years), respectively (p = 0.963). The median duration of diabetes mellitus was 42.0 months (range = 1-456 months). The prevalence of degenerative changes (calcifications, disorganized fibers and/or hypoechoic foci) was significantly higher in type 2 diabetic subjects than controls in both the right (55.0% vs. 18.8%, p <0.001) and left (52.5% vs. 18.8%, p <0.001) feet.

Conclusion: The Achilles tendons of type 2 diabetic subjects have significantly more degenerative changes than their age/ sex-matched controls in our locality. Disorganized Achilles tendon fibers occur significantly more often among male than female type 2 diabetic subjects. Disorganization of Achilles tendon fibers and hypoechoic foci are significantly more prevalent in type 2 diabetic subjects with peripheral neuropathy than those without peripheral neuropathy. Body mass index did not affect the occurrence of degenerative changes in the Achilles tendon of participants.

Keywords: Achilles tendinopathy; Achilles tendon; diabetes mellitus; tendinopathy; tendon degeneration.

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Figures

Fig. 1.
Fig. 1.
Ultrasonography of a normal Achilles tendon (arrows) showing the transducer position and equivalent sonographic image in longitudinal/long-axis view (A, B) and transverse/short-axis view (C, D)
Fig. 2.
Fig. 2.
B-mode ultrasound image of the Achilles tendon (longitudinal view) showing hypoechoic foci (arrows) within the tendon fibers (arrows)
Fig. 3.
Fig. 3.
B-mode ultrasound image of the Achilles tendon (longitudinal view) showing disorganization of the Achilles tendon fibers (arrows)
Fig. 4.
Fig. 4.
B-mode ultrasound image of the Achilles tendon (transverse view) showing the presence of calcific focus (arrow) within the Achilles tendon fibers
See this image and copyright information in PMC

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