Diabetic muscle infarction

Umpiérrez, Guillermo E.; Stiles, R G; Kleinbart, Jennifer; Krendel, David A.; Watts, Nelson B.

doi:10.1016/s0002-9343(96)00156-8

Cited by 112 publications

(89 citation statements)

References 13 publications

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“…3 Systemic symptoms like fever are rarely observed in this condition, unlike in infectious processes, where fever predominates. 4,5 Regardless, because the clinical findings of diabetic muscle infarction are nonspecific and often mimic other conditions such as DVT, pyomyositis, muscle abscess, muscle neoplasm, myonecrosis/necrotizing fasciitis, and hematoma, many cases are likely to go undiagnosed or may be treated inappropriately.…”

Section: Discussionmentioning

confidence: 99%

Risking Life and Limb: A Case of Spontaneous Diabetic Muscle Infarction (Diabetic Myonecrosis)

2015

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Diabetic muscle infarction, also known as diabetic myonecrosis, is a microvascular complication of poorly controlled diabetes mellitus characterized by unilateral limb pain and swelling. Because these symptoms closely mimic cellulitis and thromboembolism, diagnosis is often delayed or missed altogether, leading to increased morbidity and inappropriate treatment. We describe a case of unilateral limb pain and swelling due to diabetic muscle infarction in a 36-year-old patient with poorly controlled diabetes mellitus. We also review the literature on the diagnosis, prognosis, and management of this underrecognized condition.

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Section: Discussionmentioning

confidence: 99%

Risking Life and Limb: A Case of Spontaneous Diabetic Muscle Infarction (Diabetic Myonecrosis)

2015

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“…Since then, considerable experience has accumulated through case reports and review of previously published cases. [2][3][4][5][6][7][8][9][10][11][12][13][14] Diabetic muscle infarction is a distinct entity with characteristic clinical and radiological findings. It is probably more common than previously recognized.…”

Section: Discussionmentioning

confidence: 99%

“…The cause of diabetic muscle infarction appears to be diabetic microvascular disease since the majority of patients have multiple microvascular complications. 6,7,8 In a review of reported cases before 1996, Umpierez et al 8 found a number of risk factors for this complication, including poor diabetic control and microvascular complications (nephropathy, retinopathy, or peripheral neuropathy) in 94% of patients, insulin-dependent diabetes in 77%, and presentation with painful diffuse muscle swelling in 100%. Failure to recognize this complication usually results in extensive testing and sometimes in unnecessary surgery, as occurred in the second case, and sometimes in unnecessary or hazardous therapy, as in our first case.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Muscle Infarction – An Often Missed Complication

2003

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M Hammoudeh, I Khanjar, S Mehdi, Diabetic Muscle Infarction -an Often Missed Complication. 2003; 23(6): 394-396 Diabetic muscle infarction (DMI), or myonecrosis, is an uncommon and often missed complication of diabetes. It occurs in both types of diabetes, but more often in type 1 and appears to be attributable to microangiopathy. It has a characteristic clinical presentation, including acute onset of painful swelling most commonly in the thigh or calf muscles in the absence of systemic manifestation. It is frequently misdiagnosed clinically as neoplasm, abscess, focal myositis, or deep vein thrombosis. Magnetic resonance imaging (MRI) is extremely helpful in making the diagnosis and excluding other possibilities. It usually improves gradually to complete resolution within weeks to a few months. The two cases described emphasize the importance of early recognition and diagnosis of this complication to avoid an unnecessary intervention or hazardous treatment. CaseCase 1. A 62-year-old female patient presented with a three-day history of pain and swelling of the left leg, which had gradually increased over the last 24 hours prior to admission. There was no history of trauma, fever or previous history of similar episodes. She had had diabetes mellitus type 2 for 22 years and had been on insulin therapy for the last 5 years. She also had had hypertension for 4 years and had developed diabetic nephropathy 2 years ago. On physical examination the left calf muscle was swollen and tender, but the foot was neither swollen nor tender. A presumptive diagnosis of deep vein thrombosis (DVT) was made and she was treated with heparin. Laboratory investigation revealed WBCs of 10,700/ mm 3 with 85% granulocytes, creatinine 2.4 mg/dL, and creatinine kinase 340 IU/L (normal up to 170 IU/ L). Doppler ultrasound of the calf, done on the next day, showed edema of the gastrocnemius muscle with no evidence of DVT. Arterial Doppler study showed significant obstruction of the anterior tibial artery. MRI of the legs (Figure 1) showed swelling and high signal intensity in T2-weighted images in the left gastrocnemius and soleus muscles with subcutaneous edema. A diagnosis of DMI was made. Heparin was replaced by analgesics and the patient was advised to rest in bed. The swelling subsided significantly within 4 weeks and almost returned to normal after 8 weeks with disappearance of the pain.

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“…2 The patients usually present with rapid onset of pain in affected muscle associated with swelling and tenderness. 3 Case reports. 4,5,6 case series.…”

Section: Introductionmentioning

confidence: 99%

“…4,5,6 case series. 3 as well as systemic review. 7 have shown that diabetic muscle infarction commonly affects lower limb.…”

Section: Introductionmentioning

confidence: 99%

Diabetes Induced Bilateral Upper Limb Myonecrosis, an Unusual Complication of Chronic Type 2 Diabetes Mellitus : A Case Report

Walke¹,

Sawardekar²,

Nene³

et al. 2015

jemds

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Diabetic myonecrosis, one of the complications of chronic, inadequately controlled diabetes mellitus is seen more commonly in lower extremities and in females. We report a case of diabetic myonecrosis in upper extremities, an underreported complication of diabetes in a male from a tertiary care hospital in Mumbai. Diabetic myonecrosis usually responds to conservative management, but the long-term prognosis of the condition is poor. Identification and correct diagnosis of diabetic myonecrosis is important to avoid wrong treatment which could result in unnecessary complications.

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Diabetic muscle infarction

Cited by 112 publications

References 13 publications

Risking Life and Limb: A Case of Spontaneous Diabetic Muscle Infarction (Diabetic Myonecrosis)

Risking Life and Limb: A Case of Spontaneous Diabetic Muscle Infarction (Diabetic Myonecrosis)

Diabetic Muscle Infarction – An Often Missed Complication

Diabetes Induced Bilateral Upper Limb Myonecrosis, an Unusual Complication of Chronic Type 2 Diabetes Mellitus : A Case Report

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