Limited joint mobility in Sri Lankan patients with non-insulin- dependent diabetes

Two hundred and sixteen patients with non-insulin-dependent diabetes(NIDDM) and 216 age- and gender-matched controls were studied to assess theprevalence of limited joint mobility (LJM). Joint mobility was measured bygoniometry at metacarpophalangeal and subtalar joints, and those in whom aprayer sign was elicited were said to have cheiroarthropathy. Fortydiabetic patients and 10 controls had cheirorathropathy. The mean range ofmotion was reduced at metacarpophalangeal joints in diabetic patients withcheiroarthropathy (36.8 +/- 9.2) and without cheiroarthropathy (45.7 +/-8.1) when compared to controls (51.4 +/- 9, P < 0.01). Mobility atsubtalar joints was reduced in those with cheiroarthropathy (25 +/- 5.3, P< 0.01) when compared to controls (32.4 +/- 4.1) and diabetic patientswithout cheiroarthropathy (27.4 +/- 4.6). No differences in subtalarmobility existed between diabetic patients without cheiroarthropathy andcontrols. Significant differences were observed in the presence of footulceration (35 vs 16%) in those with and without cheiroarthropathy. Weconclude that cheiroarthropathy is seen in Sri Lankan patients with NIDDMand that significant limitation of joint mobility is present in patientswith NIDDM who do not have overt cheiroarthropathy and that overtcheiroarthropathy may be a marker for a high risk of foot ulceration.