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CASE REPORT
Year : 2020  |  Volume : 17  |  Issue : 1  |  Page : 18-19

Prevalence of periarthritis in diabetic patients


Department of Ortho SGMC and RF, Venjaramoodu, Kerala, India

Date of Submission11-Oct-2020
Date of Acceptance27-Oct-2020
Date of Web Publication17-Nov-2020

Correspondence Address:
S Anoop
NLRA 240 A, Neerazhi Lane, Ulloor, Trivandrum - 695 011, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joasis.joasis_5_20

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  Abstract 


In this study, we have evaluated the prevalence of periarthritis in diabetes above the age group of 50 years in a population residing in Venjaramoodu, Trivandrum. There were a few exclusion criteria. This is a cross-sectional study which includes 100 participants selected from the patients of periarthritis. Data were analyzed using the percentage analysis method. This study showed that 36% of patients of periarthritis attending the orthopedic outpatient department had diabetes mellitus. We come to the conclusion that the prevalence of periarthritis is more in diabetic individuals and that periarthritis is more common in uncontrolled diabetes.

Keywords: Diabetes, periarthritis, shoulder


How to cite this article:
Vishnu R P, Raffic M, Anoop S. Prevalence of periarthritis in diabetic patients. J Orthop Assoc South Indian States 2020;17:18-9

How to cite this URL:
Vishnu R P, Raffic M, Anoop S. Prevalence of periarthritis in diabetic patients. J Orthop Assoc South Indian States [serial online] 2020 [cited 2020 Nov 25];17:18-9. Available from: https://www.joasis.org/text.asp?2020/17/1/18/300758




  Introduction Top


Nevaiser renamed periarthritis as adhesive capsulitis in 1946 12 years after being introduced by Codman in1934. Periarthritis shoulder is a group of symptoms with pain, stiffness, and/or functional deficit at the glenohumeral joint. The onset is insidious and progresses through several stages, usually during the course of 1–2 years. These stages include the freezing phase or painful phase, the frozen phase or stiff phase, and the thawing or resolution phase.

Aim and objective

  1. To evaluate the Prevalence of periarthritis in diabetic patients above the age group of 50 years attending the ortho outpatient department (OPD), SGMC and RF Venjaramoodu, Trivandrum
  2. To compare the correlation between periarthritis and diabetes.


Criteria to select the group

Exclusion criteria

  1. Juvenile diabetes
  2. Age <50 years
  3. Previous injury to the shoulder
  4. Osteoarthritis
  5. Infective pathology around the shoulder
  6. Mental retarded patients.



  Materials and Methods Top


This is a cross-sectional study which includes 100 participants selected from the patients of periarthritis aged 50 years and above attending the orthopedic OPD in Gokulam Medical College, Venjaramoodu. In this study, the prevalence of diabetes is seen to be 38.6% in patients with periarthritis of the shoulder. The formula to calculate sample size is 4 pq/E2, where E is 10% and q is 1 − p (E indicates error and P indicates prevalence). The sample size is calculated by applying this formula and found to be 94.4, so a total of 100 participants are included in the present study. Periarthritis was diagnosed based on clinical examination. The diagnosis of periarthritis was confirmed after taking X-ray of the affected shoulder, to rule out any other causes of similar shoulder diseases such as osteoarthritis shoulder and caries sicca. Patients with the H/O surgery, trauma, rheumatoid arthritis, gout, paralysis, and myocardial infarction were not included in the study. A detailed history of shoulder symptoms and diabetes is taken from every patient. Physical examination and detailed examination of affected as well as other shoulder were performed. All patients were then investigated for fasting and postprandial blood sugar levels and glycated hemoglobin (HbA1c). Data were analyzed using the percentage analysis method. [Table 1], [Table 2], [Table 3], [Table 4]
Table 1: Gender wise distribution of study subjects

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Table 2: Age wise distribution of subjects

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Table 3: Diabetic status

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Table 4: Glycaemic control among subjects

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  Results Top


There were 48 females (48%) and 52 males (52%) in the study group. Their mean age was 57.80 years. There were 18 patients (18%) in the age group of 50–55 years, 49 patients (49%) in the age group of 55–60 years, 30 patients (30%) in the age group of 60–65 years, and 3 patients (3%) were above 65 years of age. There was a history of diabetes in 41% of the total participants in their immediate family (siblings or parents or both).


  Discussion Top


This study showed that 36% [Table 3] of patients of periarthritis attending the orthopedic OPD had diabetes mellitus. Among them, 23% were known diabetics and 13% had undiagnosed diabetes. [Table 3] 11% had their HbA1c in the prediabetic range, i.e., between 5.7% and 6.4%. Rest 53% of patients of periarthritis were found to be normoglycemic. Forty-one percent of patients had a history of diabetes mellitus in their immediate family.

A prevalence of diabetes is found to be 36% in the patients with periarthritis in the current study. The results of this study are consistent with other studies conducted when it comes to the prevalence of diabetes in periarthritis shoulder patients.[1] According to the results of another study, the prevalence of diabetes mellitus was found to be 30% in patients of periarthritis.[2]

Out of all the patients of periarthritis with diabetes, 61% [Table 4] showed poor diabetic control and 39% showed good diabetic control as indicated by their HbA1c levels. These findings are consistent with a study conducted by Chan et al. which showed that patients with poorly controlled blood sugar levels over a prolonged time interval have an increased possibility of developing periarthritis.[3] In another study, it was concluded that glycemic control assessed by HbA1c is a very important factor affecting the development of musculoskeletal manifestations in Type 2 diabetes mellitus.


  Conclusion Top


Prevalence of periarthritis is more in diabetic individuals.

Periarthritis is more common in uncontrolled diabetes.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Tighe CB, Oakley WS Jr. The prevalence of a diabetic condition and adhesive capsulitis of the shoulder. South Med J 2008;101:591-5.  Back to cited text no. 1
    
2.
Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: A meta-analysis of prevalence. Muscles Ligaments Tendons J 2016;6:26-34.  Back to cited text no. 2
    
3.
Chan JH, Ho BS, Alvi HM, Saltzman MD, Marra G. The relationship between the incidence of adhesive capsulitis and hemoglobin A1c. J Shoulder Elbow Surg 2017;26:1834-7.  Back to cited text no. 3
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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Abstract
Introduction
Materials and Me...
Results
Discussion
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