Diabetic Cherioarthropathy, a Clue for Uncontrolled Diabetes: Case Report and Review of the Literature

Edrees Amr

doi:10.23937/2378-3656/1410327

Abstract

Diabetes mellitus is associated with a wide variety of musculoskeletal manifestations which can significantly affect a patient's quality of life. One of these manifestations is Limited joint mobility syndrome (LJMS) also known as diabetic cheiroarthropathy (DCA) which affects the hands. Herein is a case of a 50-year-old female patient with type 2 diabetes mellitus who was diagnosed with DCA after complaining of limited movements of all joints in her hands and tightening of the skin. Her diabetes mellitus was uncontrolled, and she was found to have diabetic nephropathy and non-proliferative diabetic retinopathy.

Highlights

IntroductionMusculoskeletal disorders such as Achilles tendon pathology, trigger finger, Dupuytren’s, limited joint mobility syndrome (LJMS), carpal tunnel syndrome, frozen shoulder and plantar fasciitis have been found to occur more often in subjects with diabetes compared to those without diabetes [1]
Musculoskeletal disorders such as Achilles tendon pathology, trigger finger, Dupuytren’s, limited joint mobility syndrome (LJMS), carpal tunnel syndrome, frozen shoulder and plantar fasciitis have been found to occur more often in subjects with diabetes compared to those without diabetes [1].LJMS is one of the musculoskeletal disorders and is rather underexposed and under diagnosed compared to the well-known micro- and macrovascular complications of diabetes
The diagnosis of LJMS is based on clinical examination and can identify patients who are at risk for serious diabetes complications

Summary

Introduction

Musculoskeletal disorders such as Achilles tendon pathology, trigger finger, Dupuytren’s, limited joint mobility syndrome (LJMS), carpal tunnel syndrome, frozen shoulder and plantar fasciitis have been found to occur more often in subjects with diabetes compared to those without diabetes [1]. There was no dysphagia, no dry eyes, and no dry mouth Review of her chart showed that she lost to follow up on her diabetes for about a year and presented to her primary care physician with symptoms of uncontrolled DM, in addition to her hand’s symptoms. Her glycosylated hemoglobin (HbA1c) was 10%, she was on treatment with oral hypoglycemic agents Her hands examination showed thick, tight, waxy skin with limited joint range of motion (inability to fully flex or extend the fingers) (Figure 1). There was no evidence of flexors tendons synovitis Her investigations showed normal ESR, CRP, Negative rheumatoid factor, anti-CCP. Further work up done by her primary care physician showed microalbuminuria indicating diabetes nephropathy, and non-proliferative diabetes retinopathy

Discussion

Conclusion