When ultrasound reveals shoulder muscles that appear especially “bright,” it may be a warning sign of diabetes, according to findings to be presented at RSNA 2018 in Chicago.
Seven B. Soliman, from Henry Ford Hospital in Detroit, first noticed the pattern of deltoid muscles appearing bright in ultrasound studies more than a decade ago. Whenever he noticed the brightness, the patient would always confirm that they were, in fact, diabetic. This led Soliman and colleagues to study the pattern more closely.
The researchers gathered 137 shoulder ultrasounds from patients with type 2 diabetes, including 13 who had pre-diabetes. An additional 49 ultrasounds were obtained from obese patients without diabetes. A team of two musculoskeletal radiologists, blind to whether the patients had diabetes or not, was then asked to classify the patients based on the brightness of their shoulder muscle in the images. Classifications were “normal,” “suspected diabetes” and “definite diabetes.”
Overall, the team found a radiologist could predict type 2 diabetes in a patient nearly 90 percent of the time by focusing on the echogenicity of the muscle. In addition, the brightness was associated with pre-diabetes, meaning the patient would likely end up with diabetes unless changes were made to their daily habits. This, Soliman noted, means specialists have the opportunity to help patients avoid diabetes.
“If we observe this in patients with pre-diabetes and diabetes, we can get them to exercise, make diet modifications and lose weight,” he said in a prepared statement from RSNA. “If these interventions happen early enough, the patients may be able to avoid going on medications and dealing with all the complications that go with the disease.”
Soliman added that the researchers weren’t surprised their findings confirmed the pattern, but what did surprise them was its high accuracy. He also explained they aren’t completely sure why shoulder muscles appear so bright when the patient has diabetes. Low glycogen levels is a leading theory; research has found patients with diabetes have glycogen levels up to 65 percent lower than patients without diabetes.
“It could be that this appearance in people with diabetes and pre-diabetes is related to the known problems with glycogen synthesis in their muscles because of their insulin abnormalities,” Soliman said in the same statement.
RSNA 2018 takes place Nov. 25-30 at McCormick Place in Chicago.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.