Bones and Joints in Diabetes Mellitus by S. Forgács

By S. Forgács

Complex issues of the carbohydrate metabolism and linked problems reason many abnormalities detectable by way of radiography within the bones and joints. light medical signs linked to very serious radiological alterations have been first rec­ ognized when it comes to the gastroenterologic problems of diabetes. This phenomenon is extra widespread within the skeletal procedure. for instance, light and painless swelling of the foot joints may well usually masks tremendous serious bone destruction. a number of different bone adjustments linked to diabetes are just detectable by means of radiography. hence, the radiologist performs a major position in confirming those diabetic problems, additionally he's excited by the healing administration of the sufferer. even supposing many info in this topic were released, in spite of the fact that no summarizing monograph has but seemed. Manuals discussing diabetes comprise merely brief reports on problems of the osseous process. the truth that the occurrence of diabetes is particularly excessive, at this time 1 %-2 % of the inhabitants is affected and their quantity is progressively expanding - dis­ performs the timeliness of this topic. Fifty years of expertise with insulin treatment exhibits that numerous vital difficulties nonetheless stay to be solved. Insulin and smooth oral antidia­ betic medicines proved super effective within the administration of hyperglycemia and ketosis, however the occurrence of alternative issues has no longer reduced. additionally, because the variety of diabetics and their lifestyles expectancy elevate, overdue problems develop into likewise extra fre­ quent. Diabetic osteoarthropathy is this type of complications.

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Patients with an unstable metabolism belonged to the insulindependent group, while those with a stable metabolism belonged to the latter. I -N of o-f --'--H-y-p-er-os-to-t-iC-LNO. 3 %) Type A: insulin-dependent diabetes; Type B: non-insulin-dependent diabetes. Among 118 diabetics with hyperostotic spondylosis, only 15 needed chronic insulin treatment. Detailed analyses revealed that in patients who received oral treatment or those who had to control a diet alone (Type B), the incidence of hyperostotic spondylosis was almost three times higher than in the group treated with insulin (Table 9).

Fii16p (1961), reporting 9 cases of "hyperostosis vertebrae," found signs of dysplasia in only one case. Such radiographic findings were observed in 40%-45 % of our patients belonging to various groups (controls, diabetics, patients with and without hyperostotic spondylosis). Scheuermann's disease is undisputedly involved in the development of spondylosis. We also observed that spondylosis always accompanied the residual symptoms of Scheuermann's disease. Nevertheless, other factors are also necessary for the development of hyperostotic spondylosis.

The sacroiliac space is hardly visible; the calcified sacroiliac ligaments form an osseous bridge at the caudal part of the joint. Large paraacetabular osteophyte and calcification in the caudal recesses of the hip joint capsule. Calcification of the sacrotuberous ligament appears extending superiorly from the ischium as a calcified band. Ischial spine thickened due to calcification of the ligamentous attachment; rare forms of ligamentous calcification 53 Fig. 23. Ossified iliolumbar ligaments on both sides.

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