
==== Front
J Med Ultrasound
J Med Ultrasound
JMU
J Med Ultrasound
Journal of Medical Ultrasound
0929-6441
2212-1552
Wolters Kluwer - Medknow India

JMU-32-275
10.4103/jmu.jmu_34_24
Correspondence
Posterior Tibial Nerve Ultrasound Assessment of Peripheral Neuropathy in Adults with Type 2 Diabetes Mellitus
Al-Mendalawi Mahmood Dhahir *
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
Address for correspondence: Prof. Mahmood Dhahir Al-Mendalawi, Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad 55302, Iraq. E-mail: mdalmendalawi@yahoo.com
Jul-Sep 2024
10 7 2024
32 3 275275
30 3 2024
19 4 2024
Copyright: © 2024 Journal of Medical Ultrasound
2024
https://creativecommons.org/licenses/by-nc-sa/4.0/ This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
==== Body
pmcDear Editor,

In the January–March 2024 issue of the fabulous Journal of Medical Ultrasound, Oduola-Owoo et al.[1] reported that the ultrasonographic left posterior tibial nerve (TN) cross-sectional area (PTNCSA) was significantly larger among Type 2 diabetes mellitus (T2DM) patients with diabetic peripheral neuropathy (DPN) than T2DM patients without DPN and healthy controls. It revealed the greatest sensitivity for detecting DPN at 5 cm proximal to the medial malleolus. The PTNCSA was associated with the DPN severity. They recommended PTN ultrasonography as a further tool for screening and monitoring DPN in T2DM patients. We believe that the clinical applicability of that recommendation in practice is debatable. This is based on the fact that DPN might be asymmetrical.[2] Moreover, anatomical variations of the TN at the ankle are often encountered, and the TN variation in its branching point and cross-sectional area at the ankle is commonly correlated with certain clinical conditions such as foot neuropathy and pain.[34] Therefore, relying solely upon the left PTNCSA ultrasonography might miss a significant number of DPN patients and delay instituting proper therapy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.
==== Refs
REFERENCES

1 Oduola-Owoo LT Adeyomoye AA Omidiji OA Idowu BM Oduola-Owoo BB Odeniyi IA Posterior tibial nerve ultrasound assessment of peripheral neuropathy in adults with type 2 diabetes mellitus J Med Ultrason 2024 32 62 9
2 Chang MC Yang S Diabetic peripheral neuropathy essentials: A narrative review Ann Palliat Med 2023 12 390 8 36786097
3 Soetoko AS Fatmawati D Anatomical variations of the tibial nerve and their clinical correlation Anat Cell Biol 2023 56 415 20 37694293
4 Priya A Ghosh SK Walocha JA Tubbs RS Iwanaga J Variations in the branching pattern of tibial nerve in foot: A review of literature and relevant clinical anatomy Folia Morphol (Warsz) 2023 82 231 41 35481703
