Abstract
Aim To investigate the alterations in the plantar fascia (PF), intrinsic
muscles, and tendons in the feet of patients at high risk for developing
diabetic foot.
Methods The healthy feet of 22 patients with type 2 diabetes, who had
developed diabetic foot ulcers on a single foot without any pathology on the
contralateral extremity, and those of 22 healthy volunteers were evaluated by
magnetic resonance imaging. The volume of the Achilles tendon (AT), the surface
area of the PF, the thickness of AT, flexor hallucis longus, flexor digitorum
longus, tibialis posterior, and peroneus longus tendons, irregularity in the PF,
and edema of intrinsic foot muscles were examined.
Results Nineteen patients (86%) had irregularity in the PF,
whereas none of the healthy controls had any (p<0.001). Intrinsic muscle
edema was more common in the group with diabetes (p=0.006). The volume
of AT and the surface area of PF were decreased in patients with peripheral
arterial disease (PAD) (p<0.05). Patients with diabetes mellitus but
without PAD had a larger surface area of PF than that of controls
(p<0.05). There were no differences in the volume of AT, the surface
area of the PF, and other tendon thickness between the groups.
Conclusion Irregularity in the PF and muscle edema may indicate a high
risk for the diabetic foot. The presence of PAD may lead to regression in the
structure of AT and PF.
Key words
diabetes mellitus - tendon - Achilles - MRI - peripheral arterial disease
