2型糖尿病合并肩部疼痛患者的诊断是什么？一项前瞻性横断面研究的结果。

What Is the Diagnosis in Patients with Type 2 Diabetes Who Have a Painful Shoulder? Results from a Prospective Cross-Sectional Study.

作者信息

Alabdali Login Ahmed S., Jaeken Jasmien, van Alfen Nens, Dinant Geert-Jan, Borghans Rob A P, Ottenheijm Ramon P G

机构信息

Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.

Ministry of Education, Riyadh 12435, Saudi Arabia.

出版信息

J Clin Med. 2020 Dec 18;9(12):4097. doi: 10.3390/jcm9124097.

DOI:10.3390/jcm9124097

PMID:33353121

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7767012/

Abstract

BACKGROUND

Patients with diabetes mellitus have higher risk of developing shoulder pathology. However, only adhesive capsulitis is addressed in shoulder pain guidelines as a disorder associated with diabetes. Yet, patients with diabetes are at risk of having several other shoulder disorders, including focal neuropathy. Our aim was to quantify the presence of shoulder disorders using physical examination and ultrasound imaging in patients with type 2 diabetes (T2DM) suffering from shoulder pain in general practice.

METHODS

In this prospective cross-sectional study, patients with T2DM who had had a painful shoulder for at least four weeks were included. Patients filled out a questionnaire and underwent a physical examination of the shoulders and feet and ultrasound imaging of the shoulder.

RESULTS

A total of 66 patients were included, of whom 40.9% ( = 27) had bilateral complaints resulting in 93 symptomatic shoulders. Subacromial pain syndrome was most frequently diagnosed by physical examination (66.6%, 95% CI 51.6-72.0%; < 0.0001), while ultrasound imaging showed that subacromial disorders were statistically significantly the most prevalent (90.3%, 95% CI 81.9-95.2%). Only two patients (3%) were diagnosed with neuropathic shoulder pain.

CONCLUSION

When choosing treatment, general practitioners should be aware that in patients with T2DM the subacromial region is most frequently affected.

摘要

背景

糖尿病患者发生肩部病变的风险较高。然而，在肩部疼痛指南中，仅将粘连性肩关节囊炎作为一种与糖尿病相关的疾病进行阐述。然而，糖尿病患者还存在患其他几种肩部疾病的风险，包括局灶性神经病变。我们的目的是通过体格检查和超声成像来量化在全科医疗中患有肩部疼痛的2型糖尿病（T2DM）患者肩部疾病的存在情况。

方法

在这项前瞻性横断面研究中，纳入了肩部疼痛至少四周的T2DM患者。患者填写问卷，并接受肩部和足部的体格检查以及肩部超声成像检查。

结果

共纳入66例患者，其中40.9%（=27例）有双侧症状，导致93个肩部出现症状。肩峰下疼痛综合征在体格检查中诊断最为常见（66.6%，95%可信区间51.6 - 72.0%；<0.0001），而超声成像显示肩峰下疾病在统计学上显著最为普遍（90.3%，95%可信区间81.9 - 95.2%）。仅有2例患者（3%）被诊断为神经性肩部疼痛。