Limited Joint Mobility in Type 1 Diabetes: Diabetic Cheiroarthropathy, a Neglected Entity

Area of Science:

• Endocrinology
• Rheumatology
• Neurology

Background:

• Musculoskeletal disorders are frequent in diabetes mellitus.
• Diabetic cheiroarthropathy (DCA) is a common, debilitating complication of type 1 diabetes.
• DCA significantly impacts hand function and is linked to microvascular issues like retinopathy.

Observation:

• A 24-year-old male with a 20-year history of type 1 diabetes presented with hand motor difficulties.
• Clinical signs included positive "Namaste" and "Table Top" signs.
• Neurological examination revealed sensory loss, reduced vibration perception, and polyneuropathy.

Findings:

• The patient exhibited a restrictive pulmonary function pattern.
• High-resolution CT showed normal lung parenchyma.
• Associated conditions included proliferative diabetic retinopathy, proteinuria, vitamin D deficiency, and subclinical hypothyroidism.

Implications:

• DCA can serve as an indicator for screening other diabetic complications, especially in rural settings.
• Management focuses on physiotherapy, glycemic control, patient education, and regular monitoring.
• Surgical intervention is considered a last resort for DCA.