Quantification of early subclinical limited joint mobility in diabetes mellitus

Limited joint mobility (LJM) has been described in juvenile diabetic patients by Rosenbloom et al.; similar abnormalities are also present in adult diabetes. This modification may be associated with a high risk of microvascular complications. We tested the use of a goniometer in measuring subclinical joint limitation in 50 adult diabetic patients without overt, i.e., clinically evident, LJM as described by these authors. This diabetic population was compared with 118 nondiabetic adult controls. We found significant changes in hand mobility between the two groups for wrist flexion and extension of the 3rd and 5th fingers (P less than 0.001). Age was correlated to wrist flexion, wrist extension, and proximal interphalangeal flexion of the little finger. Wrist extension correlated with duration of diabetes (r = -0.37, P less than 0.01). Heavy manual activities significantly limited all motions except wrist and 5th finger metacarpophalangeal flexion. Early systematic examination by goniometry may prove to be a sensitive, quantitative, and inexpensive way of detecting joint stiffness at an early stage.