title: Simultaneous acute shoulder arthritis and multiple mononeuropathy in a newly diagnosed type 2 diabetes patient - First case report.
abstract: Diabetes is a common disorder that leads to the musculoskeletal symptoms such as the shoulder arthritis. The involvement of peripheral nervous system is one of the troublesome for the patients as it provokes chronic sensory symptoms, lower motor neuron involvement and autonomic symptoms. In the course of the disease there has been several types of neuropathies described. A 41-year-old male patient was admitted to the internal medicine department because of the general weakness, malaise, polydypsia and polyuria since several days. The initial blood glucose level was 780mg/dl. During the first day the continuous insulin infusion was administered. On the next day when he woke up, the severe pain in the right shoulder with limited movement, right upper extremity weakness and burning pain in the radial aspect of this extremity appeared. On examination right shoulder joint movement limitation was found with the muscle weakness and sensory symptoms in the upper limbs. The clinical picture indicated on the right shoulder arthritis and the peripheral nervous system symptoms such as the right musculocutaneous, supraspinatus, right radial nerve and left radial nerve damage. We present a first case report of simultaneous, acute involvement of the shoulder joint and multiple neuropathy in a patient with newly diagnosed type 2 diabetes, presumably in the state of ketoacidosis.
authors.affiliation: Department of Neurology, Pomeranian Medical University in Szczecin, Szczecin, Poland; Aldemed Centrum Medyczne, Zielona Góra, Poland. Electronic address: dkotlega@poczta.onet.pl.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kotlęga
authors.affiliation: Department of Neurology, Pomeranian Medical University in Szczecin, Szczecin, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Gołąb-Janowska
authors.affiliation: Magnetic Resonance Laboratory, Affidea Lubuskie Centrum Medyczne, Zielona Góra, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Zaborowski
authors.affiliation: Department of Gynaecology and Urogynaecology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Sylwester
authors.initials: S
authors.lastname: Ciećwież
authors.affiliation: Department of Neurology, Pomeranian Medical University in Szczecin, Szczecin, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Nowacki
mesh_terms: D000328:Adult; D001168:Arthritis / Q000150:complications* / Q000000981:diagnostic imaging; D002062:Bursitis / Q000150:complications* / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis; D016883:Diabetic Ketoacidosis / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020422:Mononeuropathies / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D018908:Muscle Weakness / Q000150:complications / Q000503:physiopathology; D009138:Musculocutaneous Nerve / Q000503:physiopathology; D009431:Neural Conduction; D010146:Pain / Q000150:complications; D020425:Radial Neuropathy / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Diabetes; Diabetic ketoacidosis; Diabetic neuropathy; Neuropathy; Shoulder arthritis