Evidence map›Paper›PMID 33957525›Full record

ArticleFoot (Edinburgh, Scotland)2021

Qualitative study of musculoskeletal tissues and their radiographic correlates in diabetic neuropathic foot deformity.

Mary K Hastings, Paul K Commean, Ling Chen, Jennifer A Zellers, David R Sinacore, Jonathan C Baker

Registry-linked trialOpen access · greenAbstract read
In one paragraph

Article in Foot (Edinburgh, Scotland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02616263 (Muscle, Joint and Movement Deterioration Contributing to Neuropathic Forefoot Deformity), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02616263 nacompletednot on this map

Muscle, Joint and Movement Deterioration Contributing to Neuropathic Forefoot Deformity

TypeinterventionalSponsorWashington University School of MedicineRan2016 to 2021Enrolled60ConditionsDiabetes Mellitus (DM)ArmsFoot exercise, Shoulder exercise
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Mary K HastingsProgram in Physical Therapy, Washington University School of Medicine in St. Louis, Campus Box 8502, 4444 Forest Park Blvd., Room 1101, St. Louis, MO 63108, United States. Electronic address: hastingsmk@wustl.edu.
Paul K CommeanMallinckrodt Institute of Radiology, Division of Radiological Science, Washington University School of Medicine in St. Louis, 510 South Kingshighway Blvd., St. Louis, MO 63110, United States. Electronic address: commeanp@wustl.edu.
Ling ChenDivision of Biostatistics, Washington University School of Medicine in St. Louis, Campus Box 8067, St. Louis, MO 63110, United States. Electronic address: lingchen@wustl.edu.
Jennifer A ZellersProgram in Physical Therapy, Washington University School of Medicine in St. Louis, Campus Box 8502, 4444 Forest Park Blvd., Room 1101, St. Louis, MO 63108, United States.
David R SinacoreProgram in Physical Therapy, Washington University School of Medicine in St. Louis, Campus Box 8502, 4444 Forest Park Blvd., Room 1101, St. Louis, MO 63108, United States. Electronic address: dsinacor@highpoint.edu.
Jonathan C BakerMallinckrodt Institute of Radiology, Musculoskeletal Section, Washington University School of Medicine, Campus Box 8131, St. Louis, MO 63110, United States. Electronic address: jonathancbaker@wustl.edu.
Washington University in St. Louis · USMallinckrodt (United States) · US

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
MULTICENTER CAREER DEVELOPMENT PROGRAM FOR PHYSICAL AND OCCUPATIONAL THERAPYK12HD055931 · NICHD · WASHINGTON UNIVERSITY · PI HAYES, MARCIE HARRIS · 2007 to 2021
$12.7M
MUSCLE, JOINT AND MOVEMENT DETERIORATION CONTRIBUTING TO NEUROPATHIC FOREFOOT DEFORMITYR01DK107809 · NIDDK · WASHINGTON UNIVERSITY · PI MARY K HASTINGS · 2016 to 2026
$4.3M
DOCTORAL TRAINING PROGRAM IN MOVEMENT SCIENCET32HD007434 · NICHD · WASHINGTON UNIVERSITY · PI Michael D Harris, Catherine Lang · 1993 to 2026
$4.2M
Diabetes-related Tendon Changes: Integrating Ex Vivo and In Vivo ApproachesF32DK123916 · NIDDK · WASHINGTON UNIVERSITY · PI ZELLERS, JENNIFER · 2019 to 2020
$127k
NCATS NIH HHS UL1 TR002345NICHD NIH HHS K12 HD055931NICHD NIH HHS T32 HD007434NIDDK NIH HHS F32 DK123916NIDDK NIH HHS R01 DK107809
6 · The paper itself

Abstract

backgroundDiabetes mellitus (DM) with peripheral neuropathy (PN) results in foot deformity increasing ulceration, joint dislocation, and amputation risk. This study describes the frequency and severity of foot and ankle musculoskeletal abnormalities and their relationship to radiographic alignment in people with DMPN with (DMPN + MCD) and without (DMPN - MCD) medial column deformity (MCD) compared to age- and body mass index-matched controls without DMPN or MDC.

methodsDMPN + MCD (n = 11), DMPN - MCD (n = 12), and controls (n = 12) were studied. A radiologist scored foot and ankle magnetic resonance images (MRI) for abnormalities in tendons/fascia, ligaments, muscles, joints, and bones. Higher scores represent greater abnormalities. Foot alignment was measured from lateral weightbearing radiographs. Frequency of abnormalities between groups and relationships between abnormalities and foot alignment in the combined group (n = 35) were examined.

resultsDMPN + MCD had higher total muscle, joint, and bone scores compared to controls and higher total joint scores than DMPN - MCD. DMPN - MCD had higher total muscle scores than controls. DMPN + MCD higher bone and joint scores were driven by increased frequency of osteophytes, cartilage damage, focal bone marrow edema, new bone formation, and subchondral cysts. Significant correlations included cuboid height and total bone and joint scores (ρ = -0.37 and ρ = -0.40, respectively) and talar declination angle and total joint score (ρ = 0.38).

conclusionHigh contrast resolution MRI allowed identification of structural lesions of the foot affecting the cartilage surfaces, bone marrow, and soft tissue supports in patients with DMPN + MCD. As expected, the presence of bone and joint lesions on MRI were strongly associated with DMPN + MCD; surprisingly, although the sample is small, lesions of the soft tissue supports were not associated with MCD. While MRI is not done routinely to investigate MCD, opportunistic use of the information from MRI done for the common clinical indications may allow early identification of the structural lesions associated with MCD and facilitate early, aggressive therapy. LEVEL OF EVIDENCE: III.

Indexed as

Diabetes MellitusDiabetic NeuropathiesFoot DeformitiesAnkle JointHumansMagnetic Resonance ImagingTendonsCuneiformDiabetesFatty muscle atrophySpring ligamentTalus

Identifiers

PMID33957525
PMCPMC8212350
OpenAlexW3159129822

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.