Skip to main content
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1996 Dec;55(12):907–914. doi: 10.1136/ard.55.12.907

Shoulder capsulitis in type I and II diabetic patients: association with diabetic complications and related diseases.

P E Arkkila 1, I M Kantola 1, J S Viikari 1, T Rönnemaa 1
PMCID: PMC1010343  PMID: 9014585

Abstract

OBJECTIVE: To examine the association between shoulder capsulitis and chronic diabetic complications and diseases closely related to diabetes. METHODS: A cross sectional study in 291 type I [mean (SD) age 33.2 (9.9) years] and 134 type II [61.1 (12.4) years] diabetic patients. The presence of shoulder capsulitis, Dupuytren disease, and limited joint mobility was sought. The patients were assessed for background and proliferative retinopathy, nephropathy, autonomic neuropathy, and peripheral symmetrical somatic polyneuropathy. Diseases closely related to diabetes (hypertension, history of myocardial infarction, coronary heart disease, and peripheral vascular disease) were also recorded. RESULTS: Prevalence of shoulder capsulitis was 10.3% in type I and 22.4% in type II diabetic subjects. Shoulder capsulitis was associated with the age in types I (P < 0.01) and II (P < 0.05) diabetic patients, and with the duration of diabetes in type I patients (P < 0.01). Odds ratios for autonomic neuropathy in type I and type II diabetic subjects with shoulder capsulitis were 4.1 (95% confidence interval, 1.6 to 10.9) and 2.7 (95% CI, 1.1 to 7.0), respectively, after controlling for age and duration of diabetes. Odds ratio for history of myocardial infarction in type I diabetic subjects with shoulder capsulitis was 13.7 (95% CI, 1.3 to 139.5) after controlling for age, duration of diabetes, hypertension, and smoking habits. Other associations between shoulder capsulitis and diabetic complications, related diseases, and other hand abnormalities were fully explained by age and the duration of diabetes. CONCLUSIONS: Shoulder capsulitis is common in type I and type II diabetic patients. It is associated with age in type I and II diabetic patients and with the duration of diabetes in type I patients. It is associated with autonomic neuropathy in type I and II diabetic patients and with history of myocardial infarction in type I diabetic patients, independently of time related variables.

Full text

PDF
914

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arkkila P. E., Kantola I. M., Viikari J. S. Limited joint mobility in type 1 diabetic patients: correlation to other diabetic complications. J Intern Med. 1994 Aug;236(2):215–223. doi: 10.1111/j.1365-2796.1994.tb01286.x. [DOI] [PubMed] [Google Scholar]
  2. Bridgman J. F. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis. 1972 Jan;31(1):69–71. doi: 10.1136/ard.31.1.69. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. CHARNLEY J. Periarthritis of the shoulder. Postgrad Med J. 1959 Jul;35:384–388. doi: 10.1136/pgmj.35.405.384. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Crisp A. J. Diabetes mellitus and the rheumatologist. Br J Rheumatol. 1986 May;25(2):135–137. doi: 10.1093/rheumatology/25.2.135. [DOI] [PubMed] [Google Scholar]
  5. Eadington D. W., Patrick A. W., Collier A., Frier B. M. Limited joint mobility, Dupuytren's contracture and retinopathy in type 1 diabetes: association with cigarette smoking. Diabet Med. 1989 Mar;6(2):152–157. doi: 10.1111/j.1464-5491.1989.tb02105.x. [DOI] [PubMed] [Google Scholar]
  6. Engelman R. M. Shoulder pain as a presenting complaint in upper lobe bronchogenic carcinoma: report of 21 cases. Conn Med. 1966 Apr;30(4):273–276. [PubMed] [Google Scholar]
  7. Ewing D. J., Clarke B. F. Diagnosis and management of diabetic autonomic neuropathy. Br Med J (Clin Res Ed) 1982 Oct 2;285(6346):916–918. doi: 10.1136/bmj.285.6346.916. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fisher L., Kurtz A., Shipley M. Association between cheiroarthropathy and frozen shoulder in patients with insulin-dependent diabetes mellitus. Br J Rheumatol. 1986 May;25(2):141–146. doi: 10.1093/rheumatology/25.2.141. [DOI] [PubMed] [Google Scholar]
  9. Gamstedt A., Holm-Glad J., Ohlson C. G., Sundström M. Hand abnormalities are strongly associated with the duration of diabetes mellitus. J Intern Med. 1993 Aug;234(2):189–193. doi: 10.1111/j.1365-2796.1993.tb00729.x. [DOI] [PubMed] [Google Scholar]
  10. JOHNSON J. T. Frozen-shoulder syndrome in patients with pulmonary tuberculosis. J Bone Joint Surg Am. 1959 Jul;41-A(5):877–882. [PubMed] [Google Scholar]
  11. Koskinen P. Nontransferability of C-peptide measurements with various commercial radioimmunoassay reagents. Clin Chem. 1988 Aug;34(8):1575–1578. [PubMed] [Google Scholar]
  12. Kouri T. T., Viikari J. S., Mattila K. S., Irjala K. M. Microalbuminuria. Invalidity of simple concentration-based screening tests for early nephropathy due to urinary volumes of diabetic patients. Diabetes Care. 1991 Jul;14(7):591–593. doi: 10.2337/diacare.14.7.591. [DOI] [PubMed] [Google Scholar]
  13. Morén-Hybbinette I., Moritz U., Scherstén B. The clinical picture of the painful diabetic shoulder--natural history, social consequences and analysis of concomitant hand syndrome. Acta Med Scand. 1987;221(1):73–82. doi: 10.1111/j.0954-6820.1987.tb01247.x. [DOI] [PubMed] [Google Scholar]
  14. Murray A., Ewing D. J., Campbell I. W., Neilson J. M., Clarke B. F. RR interval variations in young male diabetics. Br Heart J. 1975 Aug;37(8):882–885. doi: 10.1136/hrt.37.8.882. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Mühlhauser I. Smoking and diabetes. Diabet Med. 1990 Jan;7(1):10–15. doi: 10.1111/j.1464-5491.1990.tb01299.x. [DOI] [PubMed] [Google Scholar]
  16. Noble J., Heathcote J. G., Cohen H. Diabetes mellitus in the aetiology of Dupuytren's disease. J Bone Joint Surg Br. 1984 May;66(3):322–325. doi: 10.1302/0301-620X.66B3.6725338. [DOI] [PubMed] [Google Scholar]
  17. OLDHAM B. E. Periarthritis of the shoulder associated with thyrotoxicosis. A report of five cases. N Z Med J. 1959 Dec;58:766–770. [PubMed] [Google Scholar]
  18. Pal B., Anderson J., Dick W. C., Griffiths I. D. Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus. Br J Rheumatol. 1986 May;25(2):147–151. doi: 10.1093/rheumatology/25.2.147. [DOI] [PubMed] [Google Scholar]
  19. Rosenbloom A. L., Silverstein J. H., Lezotte D. C., Richardson K., McCallum M. Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease. N Engl J Med. 1981 Jul 23;305(4):191–194. doi: 10.1056/NEJM198107233050403. [DOI] [PubMed] [Google Scholar]
  20. STEINBROCKER O., ARGYROS T. G. The shoulder-hand syndrome: present status as a diagnostic and therapeutic entity. Med Clin North Am. 1958 Nov;42(6):1533–1553. doi: 10.1016/s0025-7125(16)34203-1. [DOI] [PubMed] [Google Scholar]
  21. STEINBROCKER O., NEUSTADT D., BOSCH S. J. Painful shoulder syndromes; their diagnosis and treatment. Med Clin North Am. 1955 Mar;12:563–585. doi: 10.1016/s0025-7125(16)34707-1. [DOI] [PubMed] [Google Scholar]
  22. SWAN D. M. Shoulder-hand syndrome following hemiplegia. Neurology. 1954 Jun;4(6):480–482. doi: 10.1212/wnl.4.6.480. [DOI] [PubMed] [Google Scholar]
  23. Sattar M. A., Luqman W. A. Periarthritis: another duration-related complication of diabetes mellitus. Diabetes Care. 1985 Sep-Oct;8(5):507–510. doi: 10.2337/diacare.8.5.507. [DOI] [PubMed] [Google Scholar]
  24. THOMPSON M. Shoulder-hand syndrome. Proc R Soc Med. 1961 Aug;54:679–681. [PMC free article] [PubMed] [Google Scholar]
  25. Wilson P. W., Anderson K. M., Kannel W. B. Epidemiology of diabetes mellitus in the elderly. The Framingham Study. Am J Med. 1986 May 16;80(5A):3–9. doi: 10.1016/0002-9343(86)90532-2. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES