Musculoskeletal Manifestations of Diabetes Mellitus

Diabetes mellitus is a multi-system disease characterized by persistent hyperglycemia that has both acute and chronic biochemical and anatomical sequel.Diabetes mellitus affects the connective tissue in a variety of ways and so we observe a variety of alterations in the locomotor system including neuroarthropathy, hyperostosis, osteoporosis, cheiroarthropathy, limited joint mobility, muscular infarctions.In this review, musculoskeletal manifestations in diabetic patients are presented. Late complications of diabetes mellitus (neuropathic arthropathy and diabetic muscle infarction), consequences of metabolic derangement inherent to diabetes (diffuse idiopathic skeletal hyperostosis, osteopenia, and osteoporosis), syndromes that may share etiologic mechanisms with changes of collagen and microvascular disease limited joint mobility syndrome, palmar flexor tenosynovitis (trigger finger), Dupuytren's disease, adhesive capsulitis of the shoulder, and reflex sympathetic dystrophy) are described. Moreover, carpal tunnel syndrome, gout, osteoarthritis and their probable association with diabetes mellitus are discussed.Effective diagnostic and therapeutic treatment strategies are discussed.