Osteoarthropathien und Periarthropathien bei Diabetes mellitus

Zusammenfassung

Eine steigende Lebenserwartung und Veränderungen im Lebensstil, die durch geringere körperliche Aktivität und eine höhere Aufnahme hochkalorischer Nahrungsmittel geprägt sind, tragen zu der weltweit steigenden Inzidenz von Diabetes mellitus bei. Neben den mikro- und makrovaskulären Komplikationen der Erkrankung haben Veränderungen am Skelettsystem einen beträchtlichen Anteil an der Komorbidität der Patienten. Von besonderer klinischer Bedeutung sind Arthropathien und Periarthropathien an den Händen, Schultern und Füßen. Obwohl diese Veränderungen mit der Dauer des Diabetes mellitus und mit dem Alter der Patienten zunehmen, konnte eine direkte Assoziation zur Stoffwechseleinstellung bisher nicht beschrieben werden. Die meisten skelettalen Komplikationen lassen sich anhand des klinischen Bildes diagnostizieren. Radiologische Befunde können ergänzend zur Differenzialdiagnose notwendig sein. Die Therapie der einzelnen Krankheitsbilder unterscheidet sich nicht von der Behandlung bei stoffwechselgesunden Patienten.

Abstract

Increasing life expectancy and changes in life style characterised by low physical activity and increased consumption of high-calorie foods contribute to the world-wide increasing incidence of diabetes mellitus. Besides the micro- and macrovascular complications of the disease, changes in the skeletal system contribute to a considerable extent to the patients’ comorbidity. Of particular clinical importance are arthropathies and periarthropathies of the hands, shoulders and feet. Although these changes increase with increasing duration of the disease and patient age, a direct association with the metabolic situation has not yet been established. Most of the skeletal complications can be diagnosed on the basis of their clinical features. Radiological findings may be necessary supplements for the differential diagnosis. Therapy for the individual clinical entities does not differ from that for metabolically healthy patients

Schlüsselwörter

Diabetes mellitus - Osteoporose - Karpaltunnelsyndrom - diabetisch-neuropathische Arthropathie - diffuse idiopathische skelettale Hyperostose

Key words

diabetes mellitus - osteoporosis - diabetic neuropathic osteoarthropathy - carpal tunnel syndrome - diffuse idiopathic skeletal hyperostosis

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