Retrospective analysis of treatment modalities in diabetic muscle infarction

Onyenemezu, Ikenna; Capitle, Eugenio

doi:10.2147/oarrr.s53757

Cited by 5 publications

(7 citation statements)

References 59 publications

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“…Some authors have recommended avoidance of PT because of prolonged recovery time 63 while others have not observed this in their study populations. 98 99 In this review, patients receiving PT had the longest mean time to symptom resolution at 76.5 days. Recovery times for other treatment modalities were 41.7 days for patients receiving bed rest, and 28.5 days with supportive care/bed rest plus a non-steroidal anti-inflammatory drug (NSAID).…”

Section: Managementmentioning

confidence: 85%

Diabetic muscle infarction: a systematic review

Horton

Taylor

Ragland

et al. 2015

BMJ Open Diab Res Care

198

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ContextDiabetic muscle infarction (DMI) is a rare complication associated with poorly controlled diabetes mellitus. Less than 200 cases have been reported in the literature since it was first described over 45 years ago. There is no clear ‘standard of care’ for managing these patients.Evidence acquisitionPubMed searches were conducted for ‘diabetic muscle infarction’ and ‘diabetic myonecrosis’ from database inception through July 2014. All articles identified by these searches were reviewed in detail if the article text was available in English.Evidence synthesisThe current literature exists as case reports or small case series, with no prospective or higher-order treatment studies available. Thus, an evidence-based approach to data synthesis was difficult. The available literature is presented objectively with an attempt to describe clinically relevant trends and findings in the diagnosis and management of DMI.ConclusionsEarly recognition of DMI is key, so appropriate treatment can be initiated. MRI is the radiological study of choice. A combination of bed rest, glycemic control, and non-steroidal anti-inflammatory drug therapy appears to yield the shortest time to symptom resolution and the lowest risk of recurrence.

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Section: Managementmentioning

confidence: 85%

Diabetic muscle infarction: a systematic review

Horton

Taylor

Ragland

et al. 2015

BMJ Open Diab Res Care

198

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“…2 The recurrence rate of DMI is found to be lowest with bed rest followed by physiotherapy and was highest in those who underwent surgery. 10 Patients with DMI are at high risk of recurrence, which is reported to be from 34.9% to 45.0% in different studies, and in about two-thirds of patients these recurrences are noted in a different location or muscle group than in the initial presentation. 2,3 Our patient had recurrence of DMI after three years with current involvement of multiple muscle groups.…”

Section: Discussionmentioning

confidence: 97%

“…Onyenemezu and Capitle compared surgery, physiotherapy and bed rest in the treatment of DMI and found that the patients undergoing surgery (muscle excision biopsy ) had signifi cantly prolonged symptom recovery time when compared to those managed by physiotherapy or bed rest. 10 Horton et al also showed that time to recovery was numerically lower in patients who received supportive care (glycaemic control and pain management/best rest) plus a nonsteroidal anti-infl ammatory drug, than those who were managed only by bed rest. 2 The recurrence rate of DMI is found to be lowest with bed rest followed by physiotherapy and was highest in those who underwent surgery.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Myonecrosis: An Unusual Mimicker of Idiopathic Inflammatory Myositis

Sureja

Devarasetti

Rajasekhar

2020

Journal of the Royal College of Physicians of Edinburgh

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Diabetic myonecrosis or diabetic muscle infarction (DMI), is a very rare and under-recognised complication of poorly controlled long-standing diabetes mellitus. We report a case of a 59-year-old male, who had diabetes for ten years. He presented with bilateral thigh pain of insidious onset for three months and difficulty in walking, with a similar episode in his right thigh in 2015. Creatine phosphokinase (CPK) was one and half times the normal upper limit. Magnetic resonance imaging (MRI) of his thighs showed symmetrical bulky muscles with hyperintensities on T2-weighted and short tau inversion recovery (STIR) images, supporting a clinical diagnosis of idiopathic inflammatory myositis (IIM). However, a review of histopathology slides of a muscle biopsy from the right vastus lateralis performed in 2015 showed muscle fibre ischaemic necrosis suggestive of muscle infarction. Thus a diagnosis of recurrent diabetic myonecrosis was made and the patient was treated with bed rest, opioids and aspirin with gradual recovery.

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“…It should be reserved for atypical clinical presentations when the standard investigation methods require further confirmation. Even though the needle/incision biopsy has been advocated instead of the excision biopsy, it is not as well tolerated by the patient [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetic Muscle Infarction—A Rare Diabetic Complication: Literature Review and Case Report

Rabczyński

Fenc

Kuźnik

et al. 2023

IJERPH

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We present a case of a 31-year-old patient with type 1 diabetes diagnosed at the age of 6. Diabetes is complicated with neuropathy, retinopathy, and nephropathy. He has been admitted to the diabetes ward due to inadequate diabetes control. Gastroscopy and abdominal CT were performed, and gastroparesis was confirmed as an explanation for postprandial hypoglycemia. During hospitalization, the patient reported sudden pain localized on the lateral, distal part of his right thigh. The pain occurred at rest and was aggravated by movement. Diabetic muscle infarction (DMI) is a rare complication of long-lasting, uncontrolled diabetes mellitus. It usually occurs spontaneously, without any previous infection or trauma, and is often misdiagnosed clinically as an abscess, neoplasm, or myositis. DMI patients suffer from pain and swelling of the affected muscles. Radiological examinations, including MRI, CT, and USG, are most important for the diagnosis, assessing the extent of involvement and differentiating DMI from other conditions. However, sometimes a biopsy and histopathological examination are necessary. The optimal treatment has still not been determined. There is also a potential risk of DMI recurrence.

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Retrospective analysis of treatment modalities in diabetic muscle infarction

Cited by 5 publications

References 59 publications

Diabetic muscle infarction: a systematic review

Diabetic muscle infarction: a systematic review

Diabetic Myonecrosis: An Unusual Mimicker of Idiopathic Inflammatory Myositis

Diabetic Muscle Infarction—A Rare Diabetic Complication: Literature Review and Case Report

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