The role of ultrasound in the diagnosis and evaluation of diabetic neuropathy in nerve roots of the foot

Objectives: The aim of this observational study was ultrasound evaluation of peripheral nerves cross-sectional area (CSA) in subjects with probable diabetic peripheral sensorimotor neuropathy (DPN). CSA was analyzed with reference to clinical and nerve conduction study’s (NCS) parameters for early diagnosis and pattern of involvement. Methods: A total of 50 patients with probable DPN due to Type 2 diabetes and 50 age-matched healthy controls underwent sonographic examinations of ulnar nerve at the lower arm, median nerve proximal to carpal tunnel, the common peroneal nerve proximal to fibular head, tibial nerve proximal to the tarsal tunnel, and sural nerve at lower third leg. Results: CSA was increased in cases of DPN as compared to healthy controls. Area changes were more marked with demyelinating pattern. Probable DPN cases with normal NCS had significantly higher number of peripheral nerves showing increased CSA as compared to healthy control. A cut-off of >4 nerve thickening showed a sensitivity of 86 %, and specificity of 56%. The neuropathy pattern in the lower limb was axonal, whereas in the upper limb, it was demyelinating with the majority showing sonographic feature of associated compressive neuropathy. Conclusion: There is an increase in CSA of peripheral nerve in diabetic patients. It can be used as a morphological marker for classifying DPN with changes being picked up earlier to NCS abnormality. Clinical neurological presentation in probable DPN can also be due to compressive neuropathy in early phases, and ultrasound can be a useful tool. Advances in knowledge: Early pick up of DPN cases shall be useful for early therapy and motivating the patients to actively participate in the treatment. Morphological changes on ultrasonography precedes the electrodiagnostic change in DPN. Symptoms of DPN is not only due to metabolic changes but also compressive neuropathy.

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High resolution ultrasonography of peripheral nerves in diabetic patients to evaluate nerve cross sectional area with clinical profile

Narayan

Goel

Singh

et al. 2021

The British Journal of Radiology

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Diagnostic Methods Used in Patient with Diabetic Peripheral Neuropathy

Samuel

Goyal

Mittal

2022

Journal of Datta Meghe Institute of Medical Sciences University

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The quality of life of patients with diabetes having peripheral neuropathy can be improved with an early detection of this detrimental diagnosis. This review summarizes the already established diagnostic methods (electrodiagnostic and sensory screening) and the recent radiological diagnostic methods (ultrasonography and magnetic resonance imaging) used in the screening of peripheral nerves health in diabetic patients. Electronic searches were conducted of databases PubMed, Scopus, Google Scholar, and Medline to retrieve the relevant studies in the review. The independent selection, appraisal, and data extraction were done by two reviewers. The searched articles were categorized into three diagnostic methods categories, namely, electrodiagnostic, sensory screening, and radiological. Two diagnostic methods were included under electro diagnostic and radiological methods and eight diagnostic tests were included under sensory screening. High-resolution ultrasonography and magnetic resonance neurography have higher sensitivity and specificity to detect early peripheral nerve lesions among all methods. This review will help clinicians to facilitate the early correct diagnosis of the severity of neuropathy in patients with diabetes.

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The role of ultrasound in the diagnosis and evaluation of diabetic neuropathy in nerve roots of the foot

Cited by 2 publications

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High resolution ultrasonography of peripheral nerves in diabetic patients to evaluate nerve cross sectional area with clinical profile

High resolution ultrasonography of peripheral nerves in diabetic patients to evaluate nerve cross sectional area with clinical profile

Diagnostic Methods Used in Patient with Diabetic Peripheral Neuropathy

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