Osseous lesions of the hand and foot in diabetes mellitus: correlation between magnification roentgenographic findings and clinical findings.

Twofold magnification radiograms of hands and feet in 384 diabetic cases were reviewed to determine the correlation between clinical findings and osseous lesions, especially early changes. A small, well-demarcated, round radiolucent lesion (small lytic lesion) was the most frequent finding in 87.2% of the 384 patients. In particular, a small lytic lesion of less than I mm in diameter was encountered in 85.9% of all cases by magnification radiography. A small lytic lesion can be thought of not only as a specific finding but also as one of the prodromic findings of diabetic osteoarthropathy. Localized osteopenia was also specific for diabetes, with a fairly high frequency (39.1%). Multivariate analysis revealed significant correlation between osseous lesions, especially small lytic lesions, and retinopathy. Significant correlation between retinopathy and osseous lesions was also identified by clinical followup cases. These facts suggest that microangiopathy may play an important role in the development of osseous involvements.