Diabetic Cheiroarthropathy in Type 1 Diabetes Mellitus and Coeliac Disease

Abstract

Diabetes mellitus can be associated with a variety of musculoskeletal disorders. Diabetic cheiroarthropathy or diabetic hand syndrome is one of the complications encountered in long-standing uncontrolled diabetes. It is characterized by limited movement of the joints of the hands along with thickening of the skin on the palmar and dorsal surfaces. There is an association between diabetic cheiroarthropathy and microvascular complications of diabetes, most commonly diabetic retinopathy. Early diagnosis of cheiroarthropathy can give the clinician an opportunity to screen for microvascular complications. Cheiroarthropathy is usually a clinical diagnosis. Treatment involves achievement of good glycemic control along with physiotherapy and occupational therapy. We have described the case of a 16-year-old adolescent male with uncontrolled type 1 diabetes and coeliac disease who presented to us with diabetic cheiroarthropathy.

Keywords: diabetic cheiroarthropathy; diabetic hand syndrome; diabetic retinopathy; dupuytren's contracture; type 1 diabetes mellitus (t1d).

Figure 1. Fixed flexion contracture at the proximal and distal interphalangeal joints of the digits

Figure 2. Thickening of the palmar surfaces of the hands

Figure 3. Positive Prayer’s sign

Figure 4. High risk feet with hallux valgus, hammer toes and exaggerated medial arches of feet