EVALUATING THE ROLE OF ULTRASOUND IN DIAGNOSING SHOULDER PAIN IN DIABETES MELLITUS

Abstract

Background: Shoulder pain is a common musculoskeletal complaint, particularly in diabetic patients, due to connective tissue remodeling, inflammation, and vascular compromise. Diabetes-related musculoskeletal complications, including adhesive capsulitis, rotator cuff tendinopathy, and bursitis, significantly impair mobility and quality of life. Ultrasound (US) has gained recognition as a cost-effective, non-invasive, and readily available imaging modality for diagnosing these conditions. This study evaluates the diagnostic accuracy of ultrasound in detecting shoulder abnormalities in diabetic patients, comparing its performance with other imaging techniques.

Objective: To assess the diagnostic value of ultrasound in evaluating shoulder pain in diabetic patients by determining its sensitivity, specificity, and correlation with clinical findings.

Methods: A cross-sectional study was conducted at DHQ DG Khan and Farooq Hospital Lahore over four months, including 80 diabetic patients with shoulder pain. Patients underwent ultrasound imaging using a Toshiba Aplio 400 ultrasound system with a 7.5–11 MHz linear probe. Shoulder abnormalities such as adhesive capsulitis, rotator cuff tendinopathy, and bursitis were assessed. Statistical analysis was performed using SPSS version 23, with chi-square tests applied to determine associations between variables.

Results: Among the 80 participants, 53.8% were women and 46.3% were men, with a mean age of 55.2 ± 10.4 years. Type 2 diabetes was present in 68.8%, while 31.3% had Type 1 diabetes. Shoulder pain was left-sided in 41.3%, right-sided in 35.0%, and bilateral in 23.8%. Ultrasound detected rotator cuff abnormalities in 50.0%, ligamentous changes in 36.3%, and bursitis in 32.5%. The sensitivity and specificity of ultrasound for detecting rotator cuff pathology were 87.24% and 91.33%, respectively. A statistically significant correlation was observed between ultrasound findings and clinical symptoms (p < 0.05).

Conclusion: Ultrasound is a highly effective imaging modality for diagnosing diabetic shoulder pain, demonstrating high sensitivity and specificity for soft tissue pathology. Its affordability, accessibility, and real-time dynamic imaging capabilities make it a practical alternative to MRI in routine clinical practice for diabetic patients.