Sonographic effect of diabetes on thickness and cross-sectional area of Achilles tendon

Abstract Background Sonographic evaluation of the Achilles tendon can reveal morphological changes associated with diabetes, potentially indicating diabetic musculoskeletal involvement and aiding early detection of tendon pathologies. Objective To compare the sonographic thickness and cross-sectional area of the Achilles tendon between diabetic and non-diabetic individuals. Methodology This case-control study was conducted at the University Ultrasound Clinic, Green Town, Lahore, Pakistan, over 7 months. A total of 60 diabetic and 66 non-diabetic patients aged 18–85 years were included through convenience sampling. Results Among 126 participants, the mean left Achilles tendon cross-sectional area was 51.70 ± 22.81 mm 2 for diabetics and 49.37 ± 12.85 mm 2 for non-diabetics ( P = 0.004). The right Achilles tendon area was 51.34 ± 23.67 mm 2 for diabetics and 49.19 ± 14.09 mm 2 for non-diabetics ( P = 0.007). Thickness was also greater in diabetics, with left and right tendon measurements averaging 5.03 mm compared to 4.25 and 4.21 mm, respectively, in non-diabetics ( P < 0.01). Conclusion The study demonstrates a significant increase in the Achilles tendon cross-sectional area and thickness in diabetic patients, suggesting a predisposition to tendinopathy. Males exhibited greater tendon dimensions than females, and both dimensions increased with age.