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

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

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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% (n = 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%; p <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.

Original languageEnglish
Article number4097
Number of pages12
JournalJournal of Clinical Medicine
Volume9
Issue number12
DOIs
Publication statusPublished - Dec 2020

Keywords

  • type 2 diabetes
  • physical examination
  • diagnosis
  • ultrasound
  • shoulder pain
  • adhesive capsulitis
  • subacromial pain syndrome
  • MUSCULOSKELETAL MANIFESTATIONS
  • ADHESIVE CAPSULITIS
  • NEUROPATHIC PAIN
  • TUNING FORK
  • POLYNEUROPATHY
  • ASSOCIATION
  • DISORDERS
  • QUESTIONNAIRE
  • VALIDATION
  • ULTRASOUND

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