Case report: diabetic muscle infarction presenting as knee arthralgia

Yoo, Wan Hee; Kim, C. H.; Park, J. H.; Kim, H. K.; Kim, J. R.; Park, T. S.; Baek, Hong Sun

doi:10.1007/s002960100124

Cited by 12 publications

(1 citation statement)

References 17 publications

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“… 3 , 10 , 14 – 20 Histologic findings are nonspecific, and usually show large areas of muscle necrosis with varying degrees of edema, regenerating muscle fibers, polymorphonuclear leukocyte cells, and hemorrhage. 21 The diagnosis is established based on the overall clinical picture and MRI findings. Biopsy is generally not recommended and is reserved for atypical cases.…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of treatment modalities in diabetic muscle infarction

Onyenemezu¹,

Capitle²

2014

OARRR

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BackgroundDiabetic muscle infarction (DMI) is a spontaneous necrosis of skeletal muscle of unknown etiology. The major risk factor is longstanding uncontrolled diabetes mellitus (DM). Optimal treatment for DMI is not known. The purpose of this study was to analyze the outcome of surgical treatment, physiotherapy, and bed rest in DMI.MethodsWe searched Medline from its inception to April 2013. We selected cases that provided sufficient data on recovery duration, recurrences, and non-recurrences. Baseline characteristics, including age, sex, microvascular complications, lesion size estimated on magnetic resonance imaging, type of diabetes, and duration of diabetes were assessed. The primary outcome was mean time to recovery from initial treatment and secondary outcomes were mean time to recurrence and recurrence rate.ResultsMean time to recovery was 149 (95% confidence interval [CI] 113–186), 71 (95% CI 47–96), and 43 (95% CI 30–57) days for surgery, physiotherapy and bed rest, respectively. These figures were statistically significant only for surgery versus physiotherapy and surgery versus bed rest (P<0.01). Mean time to recurrence was 30, 107, and 297 days for surgery, physiotherapy, and bed rest, respectively. The recurrence rate was 57%, 44%, and 24% for surgery, physiotherapy, and bed rest, respectively.ConclusionOur results show a similar outcome for physiotherapy as compared with bed rest. It also confirms nonsurgical treatment as a better therapeutic option compared with surgical treatment.

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Section: Introductionmentioning

confidence: 99%

Retrospective analysis of treatment modalities in diabetic muscle infarction

Onyenemezu¹,

Capitle²

2014

OARRR

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Der diabetische Muskelinfarkt?ein orthop�disches Krankheitsbild?

et al. 2005

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Diabetic muscle infarction (DMI) is a largely unfamiliar disease. It affects mainly patients around 40 years of age with long-standing diabetes and concomitant end-organ complications. The symptoms represent a classic pattern of a musculoskeletal disease with muscle pain without trauma, swelling, and functional impairment. Although its short-term prognosis is good, with improvement of the symptoms over weeks or months under analgesia and rest, a high recurrence rate of up to 60% can be observed. Additionaly, the long-term survival of patients after DMI is reduced mostly due to major vascular complications. Since many diabetic patients are in orthopedic care for musculoskeletal disorders, the orthopedic surgeon should be aware of this disease to avoid unnecessary invasive diagnostic procedures and initiate suitable therapy. Furthermore, a better knowledge of the disease could lead to definite conclusions regarding its real incidence and aid in establishing new therapeutic measures for prophylaxis and better long-term survival.

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Diabetic muscular infarct: an unusual cause of extremity pain and dysfunction

et al. 2011

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Diabetic muscular infarct (DMI) is a rare condition, which begins with acute onset of extremity pain and swelling. Patients usually have long-standing disease and poorly controlled diabetes mellitus (DM). Thigh muscle group is the most commonly involved side, while lower leg involvement is rare. We represent herein a 22-year-old patient with type I DM who admitted to our outpatient clinic due to painful swelling of the left leg. In physical examination, anterior left leg was painful and firm on palpation; there was diffuse swelling extending to the knee and ankle with mild local fever and redness. T2-weighted MRI demonstrated hyperintensity in left leg muscles. A biopsy confirmed the diagnosis of DMI. She was treated with glucose regulation, analgesics, antiplatelet treatment and rest. At her 6 months, recurrence of DMI was observed. DMI should be considered in diabetic patients with extremity pain and swelling. Treatment plan should include the regulation of the blood glucose and evaluation of end-organ complications, analgesia, and bed rest.

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Case report: diabetic muscle infarction presenting as knee arthralgia

Cited by 12 publications

References 17 publications

Retrospective analysis of treatment modalities in diabetic muscle infarction

Retrospective analysis of treatment modalities in diabetic muscle infarction

Der diabetische Muskelinfarkt?ein orthop�disches Krankheitsbild?

Diabetic muscular infarct: an unusual cause of extremity pain and dysfunction

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