ABSTRACT
Limited joint mobility was originally described in type 1 DM and was also referred to as diabetic cheiropathy. It consists of two major components, limitation of mobility, primarily of small joints of hands with thickening and stiffness of skin (pseudoscleroderma). It is bilateral, symmetric and painless. It can be demonstrated as an inability to oppose fingertips and palmar surfaces of the fingers of the opposite hands (Prayer Sign) (Figs 18.1 and 18.2). Diabetic cheiropathy is a clinical marker of poorly managed type 1 DM and is invariably associated with advanced microangiopathic complications. The prevalence of this condition has markedly diminished in last two decades with a better understanding of the management of type 1 DM and emphasis on a tight glycemic control with multiple injections of insulin.
