Role of ultrasound in early diagnosis of intrinsic foot muscle atrophy in diabetic patients: a comparative study with magnetic resonance imaging

Background Diabetic neuropathy is the most common disabling complication of diabetes mellitus (DM), which reduces muscles’ strength and causes diffuse muscular fatty infiltration. In addition to supporting functional mobility, posture, and balance, intrinsic foot muscles preserve the structure of the foot. It is crucial to evaluate the size and strength of the intrinsic foot muscles. Although the technique is expensive and time-consuming, magnetic resonance imaging (MRI) has been demonstrated to precisely image muscles. An option that is more accessible, less expensive, and capable of recording muscle contractions in real time is ultrasound (US) imaging. Our goal was to determine if ultrasound can reliably identify the early atrophic alterations of the intrinsic muscles in diabetic patients. Results Comparison of flexor hallucis brevis (FHB), abductor hallucis (ABH), flexor digitorum brevis (FDB), quadratus plantae (QP) and abductor digiti minimi (ABDM) muscles' cross-sectional area and their thickness by US and by MRI, between diabetic patients without neuropathy and those with mild, moderate and severe neuropathy showed a statistically significant reduction in muscle size. There is a great agreement between US and MRI in measuring the muscle cross-sectional area (CSA). Conclusions Our findings imply that the US produces intrinsic foot muscle CSA measures that are comparatively precise and dependable when compared to MRI, making it a legitimate and practical substitute for MRI in both clinical and research contexts.