October 2013

Imaging reveals intrinsic muscle deterioration in neuropathic feet

In the moment: Diabetes

By Jordana Bieze Foster

Diabetic neuropathy is associated with increased levels of intrinsic foot muscle deterioration, which may contribute to foot deformity and ulceration, according to research presented in September at the annual meeting of the American Society of Biomechanics in Omaha, NE.

Researchers from Washington University in St. Louis, MO, obtained magnetic resonance images of the feet of 23 patients with diabetic neuropathy and 12 age-matched controls.

The patients with diabetic neuropathy had significantly greater levels of intrinsic foot muscle deterioration than the controls, and this deterioration was significantly correlated with metatarsophalangeal (MTP) joint hyperextension. A 2003 Journal of Biomechanics study by the same group found that MTP joint hyperextension was an important forefoot structural predictor of increased plantar pressure in patients with diabetic neuropathy.

Neither study included diabetic patients who did not have neuropathy, so it remains unclear whether the reported changes are related to the neuropathy or the diabetes.


Cheuy VA, Hastings MK, Commean PK, et al. Intrinsic foot muscle deterioration and metatarsophalangeal joint deformity in people with diabetes and neuropathy. Presented at the American Society of Biomechanics 2013 Annual Meeting, Omaha, NE, September 2013.

Mueller MJ, Hastings M, Commean PK, et al. Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy. J Biomech 2003;36(7):1009- 1017.

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