Foot Small Muscle Atrophy Is Present Before the Detection of Clinical Neuropathy

Admin2 · May 27, 2005

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Foot Small Muscle Atrophy Is Present Before the Detection of Clinical Neuropathy
Robert L. Greenman, PHD, Lalita Khaodhiar, MD, Christina Lima, BA, Thanh Dinh, DPM, John M. Giurini, DPM and Aristidis Veves, MD

Diabetes Care 2005; Vol. 28, No. 6

OBJECTIVE—To characterize structural changes and the metabolic profile of foot muscles and correlate them with diabetic neuropathy measurements using phosphorus-31 (31P) rapid acquisition with relaxation enhancement (RARE) magnetic resonance imaging (MRI).

RESEARCH DESIGN AND METHODS—We studied 12 control subjects, 9 nonneuropathic diabetic patients, and 12 neuropathic diabetic patients using 31P RARE and proton (1H) MRI at 3 Tesla. The ratio of the total cross-sectional area of the foot to that of the muscle tissue was calculated from transaxial 1H and 31P images. The average 31P concentration across the metatarsal head region was measured from the 31P images.

RESULTS—The muscle area–to–total area ratio differed among all three groups (means ± SD): 0.55 ± 0.04 vs. 0.44 ± 0.05 vs. 0.06 ± 0.06 for control, nonneuropathic, and neuropathic subjects, respectively (P < 0.0001). The average 31P concentration also differed among all groups: 27.7 ± 3.8 vs. 21.7 ± 4.8 vs. 7.9 ± 8.8 mmol/l for control, nonneuropathic, and neuropathic subjects (P < 0.0001). The muscle area–to–total area ratio strongly correlated with clinical measurements: Neuropathy Disability Score, r = –0.83, P < 0.0001; vibration perception threshold, r = –0.79, P < 0.0001; and Semmes-Weinstein monofilaments, r = –0.87, P < 0.0001.

CONCLUSIONS—Small muscle atrophy is present in diabetes before clinical peripheral neuropathy can be detected using standard clinical techniques. The 31P RARE MRI method evaluates the severity of muscle atrophy, even in the early stages when neuropathy is absent. This technique may prove to be a useful diagnostic tool in identifying early-stage diabetic foot problems.
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One Foot In The Grave · May 31, 2005

I wonder what my chances are of getting funding from the Health Dept to include that in our annual Nvax.??

Slim & None I think!!

Admin2 Administrator Staff Member

One Foot In The Grave Active Member

20 year old with small leg and calf muscle due to the club foot surgery

Small hole in foot

Small white spots under foot causing piercing pain

Strange Small Hole On The Bottom Of My Foot

what is the Pain below small toe on bottom of foot?

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Small hole on bottom of foot

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