Diabetic cheiroarthropathy, also known as Diabetic stiff hand syndrome or limited joint mobility syndrome, is a cutaneous condition characterized by waxy, thickened skin and limited joint mobility of the hands and fingers, leading to flexion contractures, a condition associated with
diabetes mellitus
Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...
and it is observed in roughly 30% of
diabetic
Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level (hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased app ...
patients with longstanding disease.
It can be a predictor for other diabetes-related complications and was one of the earliest known complications of diabetes, first documented in 1974.
In the fingers, diabetic cheiroarthropathy can cause such extreme limited mobility that the patient is unable to fully extend the fingers in order to flatten the hand. Typically, both hands are afflicted by diabetic cheiroarthropathy, with most patients finding stiffness beginning in the little finger and spreading to the thumb. Most times, just smaller, more fragile joints are affected by it, with larger joints usually only being affected in patients with more severe or more advanced cases of diabetes.
Cheiroarthropathy has been reported in over 50% of insulin-dependent diabetic patients and approximately 75% of non insulin-dependent diabetes. Cheiroarthropathy occurs most often among patients with a longer history of diabetes and patients with a history of diabetic neuropathy.
Diagnosis
A classic test is the ''prayer sign'' which is the inability to place hands together in a praying position with the fingers fanned and to press together the palmar surfaces of the
interphalangeal joints Interphalangeal joint may refer to:
*Interphalangeal articulations of hand
The interphalangeal joints of the hand are the hinge joints between the phalanges of the fingers that provide flexion towards the palm of the hand.
There are two sets in ...
and the palms. A ''tabletop sign'' is positive in people with diabetes who are unable to lay their palms and the
volar aspect of the fingers completely flat on a horizontal surface.
Treatment
Diabetic cheiroarthropathy can be managed with pain relievers, anti-inflammatory medications, joint and muscle stretching exercises or
occupational therapy
Occupational therapy (OT) is a global healthcare profession. It involves the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or ''occupations'', of individuals, groups, or communities. The field of ...
, and better glucose monitoring and control.
See also
*
Diabetic dermadromes Diabetic dermadromes constitute a group of cutaneous conditions commonly seen in people with diabetes with longstanding disease. Conditions included in this group are:
:* Acral dry gangrene
:* Carotenosis
:* Diabetic dermopathy
:* Diabetic bulla ...
*
Necrobiosis lipoidica
Necrobiosis lipoidica is a necrotising skin condition that usually occurs in patients with diabetes mellitus but can also be associated with rheumatoid arthritis. In the former case it may be called necrobiosis lipoidica diabeticorum (NLD). NLD oc ...
*
List of cutaneous conditions
Many skin conditions affect the human integumentary system—the organ system covering the entire surface of the body and composed of skin, hair, nails, and related muscle and glands. The major function of this system is as a barrier against t ...
References
Skin conditions resulting from errors in metabolism
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