Sonographic Findings in Diabetic and Non-Diabetic Obese Patients with Knee Pain

Abstract

Background: Knee pain is a prevalent musculoskeletal complaint exacerbated by metabolic and mechanical factors such as diabetes mellitus and obesity. Despite growing evidence linking diabetes to osteoarthritis, limited research has explored their combined impact on knee joint abnormalities using sonographic imaging, especially in high-risk populations. Objective: This study aimed to evaluate and compare sonographic findings in diabetic and non-diabetic obese patients with knee pain to identify significant structural differences and their clinical implications. Methods: A cross-sectional observational study was conducted on 132 obese patients (n = 66 diabetic, n = 66 non-diabetic) presenting with knee pain at the Radiology Department of Sehat Medical Complex Hospital, Lahore. Inclusion criteria were age 20–70 years, BMI >30, and knee pain history; patients with previous knee trauma, surgery, or interventions were excluded. Sonographic assessment was performed using a Toshiba AplioMx ultrasound machine with a 7–10 MHz linear transducer. Fasting blood glucose levels were used to classify diabetes status. Data were analyzed using SPSS v21 with Chi-square tests for association, and ethical approval was obtained from the University of Lahore, following the Declaration of Helsinki. Results: Osteoarthritis was the most common finding (45.5%), significantly more prevalent in diabetic patients (66.7%) compared to non-diabetics (33.3%) (p = 0.001). Gender also showed a significant association with diabetes (p = 0.013), with higher sonographic abnormalities in females. Conclusion: Diabetic obese individuals with knee pain exhibit significantly more structural joint changes, particularly osteoarthritis, highlighting the need for early musculoskeletal screening in diabetic care. Sonography offers a valuable, non-invasive tool for early detection and targeted intervention.