High resolution ultrasonography of the tibial nerve in diabetic peripheral neuropathy
Article Category: research-article
Published Online: Dec 29, 2017
Page range: 246 - 252
Received: Sep 05, 2017
Accepted: Oct 18, 2017
DOI: https://doi.org/10.15557/jou.2017.0036
Keywords
© 2017 Kunwarpal Singh et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial 3.0 Public License.
Aim of the study
High-resolution ultrasonography of the tibial nerve is a fast and non invasive tool for diagnosis of diabetic peripheral neuropathy. Our study was aimed at finding out the correlation of the cross sectional area and maximum thickness of nerve fascicles of the tibial nerve with the presence and severity of diabetic peripheral neuropathy.
Material and methods
75 patients with type 2 diabetes mellitus clinically diagnosed with diabetic peripheral neuropathy were analysed, and the severity of neuropathy was determined using the Toronto Clinical Neuropathy Score. 58 diabetic patients with no clinical suspicion of diabetic peripheral neuropathy and 75 healthy non-diabetic subjects were taken as controls. The cross sectional area and maximum thickness of nerve fascicles of the tibial nerves were calculated 3 cm cranial to the medial malleolus in both lower limbs.
Results
The mean cross sectional area (22.63 +/− 2.66 mm2) and maximum thickness of nerve fascicles (0.70 mm) of the tibial nerves in patients with diabetic peripheral neuropathy compared with both control groups was significantly larger, and statistically significant correlation was found with the Toronto Clinical Neuropathy Score (
Conclusion
The cross sectional area and maximum thickness of nerve fascicles of the tibial nerve is larger in diabetic patients with or without peripheral neuropathy than in healthy control subjects, and ultrasonography can be used as a good screening tool in these patients.