open access

Vol 50, No 6 (2016)
Case reports
Submitted: 2015-12-25
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Simultaneous acute shoulder arthritis and multiple mononeuropathy in a newly diagnosed type 2 diabetes patient – First case report

Dariusz Kotlęga, Monika Gołąb-Janowska, Grzegorz Zaborowski, Sylwester Ciećwież, Przemysław Nowacki
DOI: 10.1016/j.pjnns.2016.07.003
·
Neurol Neurochir Pol 2016;50(6):474-480.

open access

Vol 50, No 6 (2016)
Case reports
Submitted: 2015-12-25

Abstract

Diabetes is a common disorder that leads to the musculoskeletal symptoms such as the shoulder arthritis. The involvement of peripheral nervous system is one of the troublesome for the patients as it provokes chronic sensory symptoms, lower motor neuron involvement and autonomic symptoms. In the course of the disease there has been several types of neuropathies described.

A 41-year-old male patient was admitted to the internal medicine department because of the general weakness, malaise, polydypsia and polyuria since several days. The initial blood glucose level was 780mg/dl. During the first day the continuous insulin infusion was administered. On the next day when he woke up, the severe pain in the right shoulder with limited movement, right upper extremity weakness and burning pain in the radial aspect of this extremity appeared. On examination right shoulder joint movement limitation was found with the muscle weakness and sensory symptoms in the upper limbs. The clinical picture indicated on the right shoulder arthritis and the peripheral nervous system symptoms such as the right musculocutaneous, supraspinatus, right radial nerve and left radial nerve damage.

We present a first case report of simultaneous, acute involvement of the shoulder joint and multiple neuropathy in a patient with newly diagnosed type 2 diabetes, presumably in the state of ketoacidosis.

Abstract

Diabetes is a common disorder that leads to the musculoskeletal symptoms such as the shoulder arthritis. The involvement of peripheral nervous system is one of the troublesome for the patients as it provokes chronic sensory symptoms, lower motor neuron involvement and autonomic symptoms. In the course of the disease there has been several types of neuropathies described.

A 41-year-old male patient was admitted to the internal medicine department because of the general weakness, malaise, polydypsia and polyuria since several days. The initial blood glucose level was 780mg/dl. During the first day the continuous insulin infusion was administered. On the next day when he woke up, the severe pain in the right shoulder with limited movement, right upper extremity weakness and burning pain in the radial aspect of this extremity appeared. On examination right shoulder joint movement limitation was found with the muscle weakness and sensory symptoms in the upper limbs. The clinical picture indicated on the right shoulder arthritis and the peripheral nervous system symptoms such as the right musculocutaneous, supraspinatus, right radial nerve and left radial nerve damage.

We present a first case report of simultaneous, acute involvement of the shoulder joint and multiple neuropathy in a patient with newly diagnosed type 2 diabetes, presumably in the state of ketoacidosis.

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Keywords

Diabetes, Neuropathy, Shoulder arthritis, Diabetic neuropathy, Diabetic ketoacidosis

About this article
Title

Simultaneous acute shoulder arthritis and multiple mononeuropathy in a newly diagnosed type 2 diabetes patient – First case report

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 50, No 6 (2016)

Pages

474-480

DOI

10.1016/j.pjnns.2016.07.003

Bibliographic record

Neurol Neurochir Pol 2016;50(6):474-480.

Keywords

Diabetes
Neuropathy
Shoulder arthritis
Diabetic neuropathy
Diabetic ketoacidosis

Authors

Dariusz Kotlęga
Monika Gołąb-Janowska
Grzegorz Zaborowski
Sylwester Ciećwież
Przemysław Nowacki

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