ULTRASONOGRAPHIC EVALUATION OF TALAR CARTILAGE THICKNESS IN PATIENTS WITH DIABETIC POLYNEUROPATHY

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.

Inclusion criteria

• Individuals aged between 40 and 70 years
• Individuals diagnosed with type 2 diabetes mellitus for at least 1 year
• Diagnosis of diabetic polyneuropathy confirmed by electromyography (EMG)
• No history of trauma or surgery affecting the ankle or foot

Exclusion criteria

• Presence of degenerative joint disease, rheumatologic disease, or infection affecting the foot or ankle
• History of trauma or surgical intervention involving the foot or ankle
• Presence of other systemic diseases that may cause neuropathy
• Presence of any local skin lesion or deformity that would prevent ultrasonographic assessment