Osseous Lesions of the Hand and Foot in Diabetes Mellitus: Correlation between Magnification Roentgenographic Findings and Clinical Findings

Twofold magnification radiograms of hands and feet in 384 diabetic cases were reviewed to deter­ mine the correlation between clinical findings and osseous lesions, especially early changes. A small, well-demarcated, round radiolucent lesion (small lytic lesion) was the most frequent finding in 87.2% of the 384 patients. In particular, a small lytic lesion of less than I mm in diameter was encountered in 85.9% of all cases by magnification radiography. A small lytic lesion can be thought of not only as a specific finding but also as one of the prodromic findings of diabetic osteoarthropathy. Localized osteopenia was also specific for diabetes, with a fairly high frequency (39.1%). Multivariate analysis revealed significant correlation between osseous lesions, especially small lytic lesions, and retinopathy. Significant correlation between retinopathy and osseous lesions was also identified by clinical follow­ up cases. These facts suggest that microangiopathy may play an important role in the development of osseous involvements.