{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:29:05Z","timestamp":1771921745170,"version":"3.50.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009053","name":"Wellcome Trust DBT India Alliance","doi-asserted-by":"publisher","award":["IA\/CPHE\/19\/1\/504607"],"award-info":[{"award-number":["IA\/CPHE\/19\/1\/504607"]}],"id":[{"id":"10.13039\/501100009053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Clin. Diabetes Healthc."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hand conditions in diabetes, namely, limited joint mobility (LJM), flexor tenosynovitis (FT), carpal tunnel syndrome (CTS), and Dupuytren disease (DD), share a common pathophysiological process involving pro-fibrotic inflammation in flexor structures. A unified, quantitative measure of disease severity across these conditions is lacking, limiting correlational research. We evaluated mean metacarpophalangeal (MCP) joint extension as a potential measure of severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We assessed 2,405 adults, including individuals with type 1 diabetes (n=291), type 2 diabetes (n=877), prediabetes (n=326), and non-diabetic controls (n=911). MCP extension was calculated as the average maximum passive extension of the second to fifth fingers, measured with a protractor. Validity was determined by correlating MCP extension with physician-rated severity (convergent) and hand grip strength and the Duru\u00f6z Hand Index (DHI, both divergent). Inter-rater reliability was tested in 128 individuals, and sensitivity to change was evaluated in 143 participants assessed at two time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean MCP extension was significantly lower in individuals with all hand conditions (42.4\u00b0 LJM, 42.8\u00b0FT, 39.9\u00b0 DD, 51.7 \u00b0CTS) than in those without (58.6\u00b0, all p&amp;lt;0.05). MCP extension correlated with physician-rated severity (\u22120.5, p&amp;lt;0.01) and weakly with DHI (R\n                      <jats:sup>2<\/jats:sup>\n                      = 0.03) and grip strength (R\n                      <jats:sup>2<\/jats:sup>\n                      = 0.07). Inter-rater reliability was strong (ICC 0.72), and MCP extension demonstrated sensitivity to change, worsening over 8 months (SRM \u22120.61).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mean MCP extension is a valid, reliable, and responsive measure for assessing fibro-inflammatory hand conditions in diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/ctri.nic.in\/Clinicaltrials\/login.php<\/jats:ext-link>\n                      , identifier CTRI\/2020\/12\/030057.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcdhc.2025.1650796","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T05:19:11Z","timestamp":1768454351000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prospective validation of mean metacarpophalangeal joint extension as a measure of diabetes-related fibrotic hand manifestations"],"prefix":"10.3389","volume":"6","author":[{"given":"Sanat","family":"Phatak","sequence":"first","affiliation":[{"name":"King Edward Memorial Hospital and Research Centre","place":["Pune, India"]},{"name":"Byramjee Jeejeebhoy Government Medical College","place":["Pune, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarita","family":"Jadhav","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital and Research Centre","place":["Pune, 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