Fig. 2

A 63-year-old male patient diabetic for 28 years on insulin treatment with uncontrolled blood sugar and elevated Hb A1c, presented with bilateral lower limb numbness, tingling, and burning sensation as well as axonal neuropathy on nerve conduction study. High-resolution ultrasound A shows the right PTN in relation to the PTA with its CSA measuring 20 mm². B B-mode image shows the longitudinal axis of the right PTN. C The right image is the B-mode, and the left image measures the elasticity of the PTN (76.2 kPa) with a color-coded box, circular ROI (T1) for quantitative measurements and a color code scale at the top side of the image. D demonstrates the left PTN in relation to the PTA with its CSA measuring 15 mm². E B-mode image shows the longitudinal axis of the left PTN. F The elasticity of the PTN (45.7 kPa) with a color-coded box, circular ROI (T2) for quantitative measurements, and a color code scale at the top side of the image. There is an increase in the CSA and stiffness of both posterior tibial nerves