Saroha Amit, Saran Sonal, Saxena Sudhir, Kant Ravi, Bhadoria Ajeet Singh
Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of General Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Med Ultrasound. 2023 Feb 13;31(4):282-286. doi: 10.4103/jmu.jmu_109_22. eCollection 2023 Oct-Dec.
Diabetes mellitus (DM) can contribute to the development of foot ulcers, a known complication of DM with a high financial and social burden. Achilles tendon (AT) and plantar fascia (PF) are well known to play an important role in foot biomechanics. The present study focuses on the alteration in thickness and stiffness of the AT and PF in Type 2 DM patients compared with the normal controls.
A cross-sectional observational study was conducted with 55 DM patients and 55 healthy volunteers as controls. The thickness of the AT and PF were measured using B-mode ultrasound and stiffness was measured using shear wave elastography. Both the thickness and stiffness in the patient group and controls were compared. The values were also compared with the clinical and demographic profiles of the patients.
DM patients had considerably thicker AT and PF than controls ( < 0.05); mean values of AT thickness for DM patients and controls were 5.66 ± 0.54 mm and 4.61 ± 0.39 mm, respectively, and for PF were 2.53 ± 0.51 mm and 1.97 ± 0.19 mm, respectively. Furthermore, the stiffness of AT and PF was significantly ( < 0.05) lower in DM patients compared to controls, suggestive of softening of AT and PF in Type 2 DM patients. Mean values of shear wave velocity for DM patients and controls in AT were 5.53 ± 0.54 m/s and 7.25 ± 0.61 m/s, respectively, and for PF, 4.53 ± 0.89 m/s and 6.28 ± 0.88 m/s, respectively.
We conclude that there is softening and thickening of the AT and PF in Type 2 DM patients, which can impair foot biomechanics.
糖尿病（DM）可促使足部溃疡的形成，这是一种已知的糖尿病并发症，会带来高昂的经济和社会负担。众所周知，跟腱（AT）和跖腱膜（PF）在足部生物力学中发挥着重要作用。本研究聚焦于2型糖尿病患者与正常对照组相比，跟腱和跖腱膜厚度及硬度的变化。
进行了一项横断面观察性研究，纳入55例糖尿病患者和55名健康志愿者作为对照。使用B型超声测量跟腱和跖腱膜的厚度，使用剪切波弹性成像测量硬度。比较了患者组和对照组的厚度及硬度值。还将这些值与患者的临床和人口统计学特征进行了比较。
糖尿病患者的跟腱和跖腱膜明显比对照组厚（<0.05）；糖尿病患者和对照组跟腱厚度的平均值分别为5.66±0.54毫米和4.61±0.39毫米，跖腱膜厚度的平均值分别为2.53±0.51毫米和1.97±0.19毫米。此外，与对照组相比，糖尿病患者跟腱和跖腱膜的硬度显著降低（<0.05），提示2型糖尿病患者的跟腱和跖腱膜软化。糖尿病患者和对照组跟腱剪切波速度的平均值分别为5.53±0.54米/秒和7.25±0.61米/秒，跖腱膜的分别为4.53±0.89米/秒和6.28±0.88米/秒。
我们得出结论，2型糖尿病患者存在跟腱和跖腱膜软化及增厚的情况，这可能会损害足部生物力学。
