(BMJ)—A 52-yo man w/ type 2 DM, diabetic retinopathy, and poor glucose control (HbA1c 10.6%) presented w/ stiffness and limited movement in both hands. Exam: skin waxy and tight over joints. Limited ROM of proximal interphalangeal and metacarpophalangeal joints bilaterally. What is the dx?
Diabetic osteoarthropathy
Diabetic cheiroarthropathy
Stenosing flexor tenosynovitis
Scleroderma diabeticorum
Carpal tunnel syndrome
You are correct. Diabetic cheiroarthropathy was diagnosed based on the positive “prayer sign”—the inability to completely close the gaps between opposing fingers and palms when the hands are pressed together. The prevalence of diabetic cheiroarthropathy is around 30% in people w/ DM. It has been assoc w/ microvascular complications. Tx includes tight glycemic control w/ stretching exercises.

BMJ 2017;359:j4878