Quantitative Muscle Ultrasonography in Lower Limb Diabetic Peripheral Neuropathy

Abstract

iabetic peripheral neuropathy (DPN) is the presence of symptoms and signs of peripheral nerve dysfunction in diabetics after the exclusion of many reasons that may cause peripheral neuropathy. The early detection of symptoms of DPN invaluable, as it prevents heavy losses as ambutation. The gold standard method for evaluating muscle denervation in peripheral neuropathy is (NCS) (Werner et al., 2011). It is suggested that the CMAP amplitude is more relevant than NCV because it more closely represents axonal loss and thus represents the neuropathic functional effects. Musculoskeletal US had been used for years as a diagnostic tool. Technological progression has led up to its wide use in many specializations. Differentiation of normal and abnormal anatomical structures is one of its main indications. In patients with very small CMAPs amplitude (below 1 mV), and even in patients without a recordable amplitude, reduced amount of contractile muscle tissue could be detected by US. This study aims to evaluate the role of quantitative muscle US in diagnosis of neuropathic pattern in lower limb peripheral neuropathy as compared to electrodiagnostic findings.