By Gary M. White, MD

Limited joint mobility syndrome (LJMS) or diabetic cheiroarthropathy is a long term complication of diabetes mellitus and is characterized by skin thickening and rigidity of the hands.


Typical features include progression of painless stiffness of hands and fingers, fixed flexion contractures of the small hand and foot joints, and impairment of fine motion and impaired grip strength in the hands. In advanced cases other joints may be affected.

The inability to completely approximate one or more of the digits when attempting to approximate the palmar surfaces of the palms and fingers is called the positive prayer sign. The inability to completely lay one's palms flat on a horizontal surface is called a positive tabletop sign.


Since the presence of LJMS is associated with micro- and macrovascular complications of diabetes, it is important to optimize glycemic control. This can potentially ameliorate and even complete reverse LJMS. Daily stretching exercises of joints aim to prevent or delay progression of joint stiffness, may reduce the risk of inadvertent falls and will add to maintain quality of life.

The diagnosis of LJMS is based on clinical features:


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