title: Facing the diagnostic challenge: Nerve ultrasound in diabetic patients with neuropathic symptoms.
abstract: We describe the nerve ultrasound findings in patients with type II diabetes mellitus who have neuropathic symptoms and signs.
  
  
  
  Fifty-five healthy controls and 44 diabetic patients underwent clinical, sonographic, and electrophysiological evaluation. Patients were studied at a mean of 14.3 years after disease onset.
  
  
  
  Nerve ultrasound revealed increased cross-sectional area (CSA) in peripheral nerves at compression sites (although no clinical symptoms were present) and noncompression sites. No correlation was detected between sonographic and electrophysiological findings. A CSA increase of the tibial nerve in the popliteal fossa was detected in 5 patients with neuropathic symptoms, although electrophysiology was normal.
  
  
  
  Nerve ultrasound revealed crucial morphological alterations in diabetic patients. CSA enlargement at compression sites indicates subclinical nerve affection and may indicate susceptibility to entrapment syndromes. CSA increase at noncompression sites despite normal electrophysiology suggests early morphological abnormalities. Further longitudinal studies are required to confirm our results. Muscle Nerve, 2015 Muscle Nerve 54: 18-24, 2016 Muscle Nerve 54: 18-24, 2016.
authors.affiliation: Department of Neurology, Ruhr University, St. Josef-Hospital, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Pitarokoili
authors.affiliation: Department of Neurology, Ruhr University, St. Josef-Hospital, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Antonios
authors.initials: A
authors.lastname: Kerasnoudis
authors.affiliation: Department of Neurology, Ruhr University, St. Josef-Hospital, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Behrendt
authors.affiliation: Department of Neurology, Ruhr University, St. Josef-Hospital, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Adnan
authors.initials: A
authors.lastname: Labedi
authors.affiliation: Department of Neurology, Ruhr University, St. Josef-Hospital, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Ilya
authors.initials: I
authors.lastname: Ayzenberg
authors.affiliation: Department of Neurology, Ruhr University, St. Josef-Hospital, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.affiliation: Department of Neurology, Ruhr University, St. Josef-Hospital, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Min-Suk
authors.initials: MS
authors.lastname: Yoon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging* / Q000209:etiology*; D004594:Electrophysiology; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D010525:Peripheral Nerves / Q000503:physiopathology*; D014463:Ultrasonography
keywords: cross-sectional area; diabetes mellitus type II; nerve conduction studies; nerve ultrasound; peripheral neuropathy