ULTRASONOGRAPHIC EVALUATION OF TALAR CARTILAGE THICKNESS IN PATIENTS WITH DIABETIC POLYNEUROPATHY

Overview

This study aims to evaluate talar cartilage thickness in individuals with diabetic polyneuropathy using ultrasonography and to compare the findings with those of healthy individuals. Diabetic polyneuropathy may induce biomechanical alterations in the lower extremities, which can potentially affect ankle joint structures. Ultrasonography, a non-invasive and accessible imaging method, will be used to measure cartilage thickness. The study includes individuals with Type 2 diabetes mellitus and electromyography-confirmed diabetic polyneuropathy, as well as age-matched healthy control subjects. The results are expected to improve understanding of musculoskeletal involvement in diabetic polyneuropathy and to support early detection of joint changes.

This study is designed as a cross-sectional case-control observational study aiming to evaluate talar cartilage thickness in individuals with diabetic polyneuropathy using ultrasonography. Diabetic polyneuropathy is one of the most common chronic complications of diabetes mellitus, characterized by progressive peripheral nerve dysfunction leading to sensory, motor, and autonomic impairments. These impairments result in proprioceptive deficits, reduced muscle strength, and balance disturbances, which collectively alter gait patterns and lower extremity biomechanics. Such biomechanical alterations may lead to abnormal load distribution across weight-bearing joints, predisposing these structures to progressive degenerative changes. The ankle joint, and particularly the talar cartilage, plays a fundamental role in load transmission and joint congruency. Therefore, it is hypothesized that chronic biomechanical stress and altered loading patterns may contribute to structural changes, including potential thinning or degeneration of the talar cartilage. Early detection of such alterations may provide valuable insights into musculoskeletal involvement in diabetic polyneuropathy and may contribute to the prevention of progressive joint degeneration. In this context, ultrasonography is increasingly recognized as a non-invasive, radiation-free, reproducible, and cost-effective imaging modality for the assessment of articular cartilage structures. In this study, ultrasonography will be used to measure talar cartilage thickness according to a standardized and reproducible protocol. The study population will consist of individuals with Type 2 diabetes mellitus and electromyography-confirmed diabetic polyneuropathy, as well as age- and sex-matched healthy control subjects. Talar cartilage thickness will be compared between groups, and potential associations with neuropathy severity, clinical symptom scores, and metabolic parameters will be analyzed. The findings are expected to contribute to a better understanding of the musculoskeletal manifestations of diabetic polyneuropathy and may support the development of early diagnostic and preventive strategies targeting joint involvement in this patient population.