Main description:

Complex disorders of the carbohydrate metabolism and associated complications cause many abnormalities detectable by radiography in the bones and joints. Mild clinical symptoms associated with very severe radiological changes were first rec ognized in relation to the gastroenterologic complications of diabetes. This phenomenon is more frequent in the skeletal system. For example, mild and painless swelling of the foot joints may often mask extremely severe bone destruction. Several other bone changes associated with diabetes are only detectable by radiography. Thus, the radiologist plays an important role in confirming these diabetic complications, furthermore he is involved in the therapeutic management of the patient. Although many details on this subject have been published, however no summarizing monograph has yet appeared. Manuals discussing diabetes include only short reviews on complications of the osseous system. The fact that the incidence of diabetes is very high, at present 1 %-2 % of the population is affected and their number is gradually increasing - dis plays the timeliness of this subject. Fifty years of experience with insulin therapy indicates that several important problems still remain to be solved. Insulin and modern oral antidia betic drugs proved extremely efficient in the management of hyperglycemia and ketosis, but the incidence of other complications has not decreased. Moreover, as the number of diabetics and their life expectancy increase, late complications become likewise more fre quent. Diabetic osteoarthropathy is one of these complications.

Contents:

1 Pathophysiology of the diabetic bone.- Disorders of cell population dynamics.- The role of inorganic ions and hormones.- Summary.- References.- 2 Osteoporosis and diabetes mellitus.- The author's data.- Evaluation of the author's data.- Summary.- References.- 3 Hyperostosis and diabetes mellitus.- Hyperostosis of the spine.- Cranial hyperostosis.- Other manifestations of hyperostosis.- Relationship between hyperostosis and metabolism.- Pathogenesis of hyperostosis.- Summary.- References.- 4 Diabetic osteoarthropathy.- The occurrence of diabetic osteoarthropathy.- Specific features of diabetic osteoarthropathy.- Changes in the soft tissues and clinical findings in diabetic osteoarthropathy.- Localization of diabetic osteoarthropathy.- The stages and radiological symptoms of diabetic osteoarthropathy.- Histological findings in diabetic osteoarthropathy.- Rare localizations of diabetic osteoarthropathy.- Differential diagnosis.- Pathogenesis of diabetic osteoarthropathy.- Prognosis of diabetic osteoarthropathy.- Treatment and prevention of diabetic osteoarthropathy.- Summary.- References.- 5 Metabolic joint diseases and diabetes mellitus.- Gout and diabetes mellitus.- Chondrocalcinosis and diabetes mellitus.- References.- 6 Congenital and hereditary bone disorders and diabetes mellitus.- Fetal skeletal abnormality.- Osteogenesis imperfecta and diabetes mellitus.- Achondroplasia.- Osteopoikilosis.- References.- 7 Growth and bone development in diabetic children.- References.- 8 Periarthritis of the shoulder and diabetes mellitus.- References.- 9 The connection between other disorders of the skeletal system and diabetes mellitus.- Rheumatoid arthritis.- Paget's disease.- Hyperparathyroidism.- Osteomyelitis.- Periodontal changes.- Miscellaneous.- References.- 10 Bone changes in lipoatrophic diabetes.- References.- 11 Bone fractures and diabetes mellitus.- References.- Selected bibliography.