Sonoelastographic and High Resolution Gray Scale Evaluation in Clinically Diagnosed Achilles Tendinopathy of Type 2 Diabetic Patients

Abstract

Background: Type 2 diabetes mellitus (T2-DM) often leads to various musculoskeletal changes, including alterations in the structural and mechanical properties of tendons such as the Achilles tendon (AT). This study aims to assess sonoelastographic and high-resolution gray scale sonographic changes in the AT of patients with T2-DM diagnosed with Achilles tendinopathy.

Methods: This cross-sectional study included 110 patients with T2-DM from Shri Sathya Sai Medical College & Research Institute, all of whom provided informed consent. Each subject underwent sonoelastography and high-resolution gray scale ultrasonography using a Mindray DC-80 with a high-frequency linear probe. Parameters measured included AT thickness, echotexture, and shear wave velocity (SWV), comparing those with and without neuropathy.

Results: The study cohort was divided into two groups based on the presence of diabetic neuropathy: Subgroup I (with neuropathy, n=56) and Subgroup II (without neuropathy, n=54). No significant difference in AT thickness was found between the groups (p ~0.99). However, SWV was significantly lower in Subgroup I than in Subgroup II (p < 0.001), indicating reduced tendon stiffness in patients with neuropathy.

Conclusion: Sonoelastography combined with high-resolution gray scale ultrasonography is a valuable tool for assessing changes in the Achilles tendon in patients with T2-DM. This study highlights the importance of monitoring AT properties in diabetic patients to prevent complications such as tendinopathy and ulcers.