Summary
The clinical and laboratory parameters of calcific shoulder periarthritis (CSP) were examined in 900 patients with type II diabetes mellitus as well as in 350 age- and sex-matched control subjects. A threefold increased prevalence of CSP in diabetics compared with the control group was associated with the presence of longstanding and poorly controlled diabetes, hypercholesterolemia, and hypertriglyceridemia suggesting pronounced diabetic angiopathy, as well as with minor trauma and hypomagnesemia. Aging and serum calcium concentrations were not related to the presence of CSP. Thirty-two percent of diabetics with CSP were symptomatic; 15% of them presented with severe pain and restriction of shoulder movement. These findings confirm a close pathogenetic interrelation between CSP and diabetes mellitus.
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Holt LP (1981) Rheumatological manifestations of diabetes mellitus. Clin Rheum Dis 7:723–746
Pastan R, Cohen SA (1978) The rheumatologic manifestations of diabetes mellitus. Med Clin North Am 62:829–839
Bridgman JF (1971) Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis 31:69–71
Lequesne M, Dang N, Bensasson M, Merry C (1977) Increased association of diabetes mellitus with capsulitis of the shoulder and shoulder hand syndrome. Scand J Heumatol 6:53–56
Kaklamanis P, Rigas A, Giannatos J, Matsas S, Economou RH et al. (1975): Calcification of the shoulder and diabetes mellitus. N Engl J Med 293:1266–1267
Mavrikakis ME, Drimis S, Kontoyannis DA, Rasidakis A, Moulopoulou E, Kontoyannis S et al. (1989): Calcific shoulder periarthritis (tendinitis) in adult onset diabetes mellitus: a controlled study. Ann Rheum Dis 48:211–214
Kozin F (1989) Painful shoulder and the reflex sympathetic distrophy syndrome. In: McCarty DJ (ed) Arthritis and allied conditions, 11th ed. Lea and Febriger. Philadelphia, pp 1516–1520
Pedersen HE, Key JA (1951) Pathology of calcareous tendinitis and subdeltoid bursitis. Arch Such 62:50–63
Luben RA, Sherman JK, Wadkins CL (1973) Studies of the mechanism of biological calcification. IV. Ultrastructural analysis of calcifying tendon matrix. Calcif Tissue Res 11:39–55
Selye H, Goldie I, Strebel R (1963) Calciphylaxis in relation to calcification in periarticular tissues. Clin Orthop 28:151–158
McClure J, Gardner DL (1976) The production of calcification in connective tissue and skeletal muscle using various chemical compounds. Calcif Tissue Res 22:129–135
Gartner J, Simons B (1990) Analysis of calcific deposits in calcifying tendinitis. Clin Orthop Rel Res 254:111–120
Urist MR, Moss MJ, Adams JM (1964) Calcification of tendon: a triphasic local mechanism. Arch Pathol 77:594–608
Luben RA, Wadkins CL (1971) Studies of the relationship of proton production and calcification of tendon matrix in vitro. Biochemistry 10:2183
Fisher LW, Termine JD (1985) Noncollagenous proteins influencing the local mechanisms of calcification. Clin Orthop 200:362–385
Addadi L, Weiner S (1985) Interactions between acidic proteins and crystals: stereochemical requirement in biomenerlization. Proc Natl Acad Sci USA 82:4110–4114
Poole AR, Rosenberg LC (1986) Chondrocalcin and the calcification of cartilage. Clin Orthop 208:114–118
Macnab I (1973) Rotator cuff tendinitis. Ann R Coll Surg Engl 53:271–287
The Lipid Research Clinics Coronary Primary Prevention Trial results. I. (1984) Reduction in incidence of coronary heart diseases. Lipid Research Clinics Program. JAMA 251: 351–364
Abbpt RD, Carrol R (1984) Interpreting multiple logistic regression coefficients in prospective observational studies. Am J Epidemiol 119:830–836
Lohr JR, Uhtkoff HK (1990) The microvascular pattern of the supraspinat tendon. Clin Orthop Rel Res 254:35–38
Bywaters LGE (1979) Lesions of bursae, tendons and tendon sheaths. Clin Rheum Dis. 5:883–886
Medsger TA, (1989) Calcinosis. In: McCarty DJ (ed) Arthritis and allied conditions, 11th ed. Lea and Febiger, Philadelphia, pp 1147–1151
Schiller S, Drofman A (1957) The metabolism of mucopolysaccharides in animals: the influence of insulin. J Biol Chem 227:625–632
Mavrikakis ME, Kontoyannis D, Karli J, Kittas C, Giagakou E, Moulopoulou A, Koutras D (1989) Glycosaminoglycans in urine: articular and periarticular tissues in streptozotocin diabetes in rats. Edocrinol Exp 23:295–303
Mavrikakis ME, Karli I, Antoniades LG, Sfikakis PP, Koutras DA (in press) Twenty-four hour urinary hydroxyproline estimations in streptozotocin-induced experimental diabetes mellitus. Endocrinol Exp
Hynes RO (1976) Cell surface proteins and malignant transformation. Biochem Biophys Acta 458:73–76
Brandy DK (1985) Glycosaminoglycans. In: Kelley, W, Harris A, Ruddy A, Sledge C (eds) Textbook of rheumatology. WB Saunders, Philadelphia, p 237
Mavrikakis ME, Drimis S, Olympios G, Kontoyannis D, Rokas S, Rassidakis A, Economou D (1987) Extra-articular calcifications and ossifications in diabetics. Clin Exp Reumatol 5/S-2:16
McCarty DJ, Sheldon DS, Warnock ML (1971) Inorganic pyrophosphate concentrations in the synovial fluid of arthritic patients. J Lab Clin Invest 78:216–220
Bennett RM, Lehr JR, McCarty DJ (1975) Factors affecting the solubility of calcium pyrophosphate dihydrate crystals. J Clin Invest 56:1571–1579
Freeman RM, Pearson E (1966) Hypomagnesemia of unknown etiology. Am J Med 41:645–656
Eaton RP (1986) Aldose reductose inhibition and the diabetic syndrome of limited joint mobility: implications for altered collagen hydration (suppl) Metabolism 35:119–121
Zervas J, Mavrikakis ME, Kehayoglou K (1986) HLA antigens in diabetics with calcific shoulder periarthritis. Clin Exp Rheumatol 4:351–353
Mavrikakis ME, Baltopoulos G, Kehayoglou K (1984) Serum immunoglobulin levels in diabetic patients with calcific shoulder periarthritis. IRCS Medical Science 12:108
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Mavrikakis, M.E., Sfikakis, P.P., Kontoyannis, S.A. et al. Clinical and laboratory parameters in adult diabetics with and without calcific shoulder periarthritis. Calcif Tissue Int 49, 288–291 (1991). https://doi.org/10.1007/BF02556220
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DOI: https://doi.org/10.1007/BF02556220