Case Report : Diabetic Myonecrosis , Rare but a Serious Complication of Uncontrolled Diabetes Mellitus

Abstract

Diabetic myonecrosis , is a serious complication of long standing suboptimal glycemic control observed in both type 1 and type 2 diabetes. It presents with abrupt pain and swelling of the involved extremity. Diagnosis is often delayed because it mimics several other conditions such as cellulitis, deep vein thrombosis(DVT). We present a 41 year old male with type 2 diabetes mellitus with localized , sudden onset left sided thigh pain. The left thigh pain progressively worsened with decreasing range of motion of left hip and knee joint .Diagnostic evaluation was done for this patient which included blood work up and imaging , pointing towards diabetic myonecrosis. Patient underwent fasciotomy for pain control and muscle biopsy for accurate diagnosis . Patient made an uneventful recovery and is under follow up. Myonecrosis is less known microvascular complication of diabetes and should always be kept in mind when evaluating a diabetic patient with muscle pain. The clinical course is self limiting and patients respond well to supportive medical therapy that involves bed rest , glycemic control along with analgesics .