Treatment and Outcomes of Diabetic Muscle Infarction

Kapur, Suneil; Mckendry, R. J. R.

doi:10.1097/01.rhu.0000152142.33358.f1

Cited by 74 publications

(93 citation statements)

References 38 publications

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“…Though this condition was first reported in 1965 [6], awareness amongst surgical healthcare professionals remains low [1][2][3]5,7,8]. Published studies discuss the difficulties in diagnosis, and also how this condition has a tendency to be under recognised and therefore sub-optimally managed [1][2][3]9].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…It affects both type 1 and type 2 diabetic patients, is usually self-limiting and responds well to conservative management [1][2][3][4]. It commonly affects the lower limb with thigh muscles being most commonly involved [1,3]. The disease commonly affects women (61.5% of all cases), type 1 diabetes patients (59% of all cases) and patients with long-standing diabetes (mean duration of disease 14.3 years) [2].…”

Section: Introductionmentioning

confidence: 99%

“…Although it most commonly involves a single limb, bilateral involvement has been described in 8.4%of cases [2]. Since the condition presents with characteristic symptoms of compartment syndrome [1][2][3], it can easily be misdiagnosed and treated surgically. Operative intervention increases morbidity and prolongs recovery of the patient [1][2][3]5].…”

Section: Introductionmentioning

confidence: 99%

“…Since the condition presents with characteristic symptoms of compartment syndrome [1][2][3], it can easily be misdiagnosed and treated surgically. Operative intervention increases morbidity and prolongs recovery of the patient [1][2][3]5]. We report a case of diabetic myonecrosis presenting with symptoms of compartment syndrome and its management.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Diabetic Myonecrosis Mimicking Acute Compartment Syndrome of the Thigh

Hachem¹

2017

MOJOR

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Diabetic Myonecrosis Mimicking Acute Compartment Syndrome of the Thigh

Hachem¹

2017

MOJOR

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Myopathies due to Systemic Disease

Briemberg

2013

Neurological Disorders Due to Systemic Disease

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A sheep in wolf's clothing

Shawa

Hasbun²

2013

Journal of Hospital Medicine

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The approach to clinical conundrums by an expert clinician is revealed through the presentation of an actual patient's case in an approach typical of a morning report. Similarly to patient care, sequential pieces of information are provided to the clinician, who is unfamiliar with the case. The focus is on the thought processes of both the clinical team caring for the patient and the discussant. A 51-year-old man presented with severe pain and swelling in the lower anterior right thigh. He stated that the symptoms limited his movement, and began 4 days prior to this presentation. He rated the pain severity a 10 on a 10-point scale. He denied fevers, chills, or history of trauma or weight loss.Cellulitis of the lower extremity is the most likely possibility, but the presence of severe pain and swelling of an extremity in the absence of trauma should always make the clinician consider deep-seated infections such as myositis or necrotizing fasciitis. An early clue for necrotizing fasciitis is severe pain that is disproportionate to the physical examination findings. Erythema, bullous lesions, or crepitus can develop later in the course. The absence of fever and chills also raises the possibility of noninfectious causes such as unrecognized trauma, deep vein thrombosis, or tumor.The patient had a 15-year history of type 2 diabetes complicated by end-stage renal disease secondary to diabetic nephropathy for which he had been on hemodialysis for 5 months, proliferative diabetic retinopathy that rendered him legally blind, hypertension, and anemia. He stated that his diabetes had been poorly controlled, especially after he started dialysis.A history of poorly controlled diabetes mellitus certainly increases the risk of the infectious disorders mentioned above. The patient's long-standing history of diabetes mellitus with secondary nephropathy and retinopathy puts him at higher risk of atherosclerosis and vascular insufficiency, which consequently increase his risk for ischemic myonecrosis. Diabetic amyotrophy (diabetic lumbosacral plexopathy) is also a possibility, as it usually manifests with acute, unilateral, and focal tenderness followed by weakness involving a proximal leg. However, it typically occurs in patients who have been recently diagnosed with type 2 diabetes mellitus or whose disease has been under fairly good control and usually is associated with significant weight loss.The patient was on oral medications for his diabetes until 1year before his presentation, at which point he was switched to insulin therapy. His other medications were amlodipine, lisinopril, aspirin, sevelamer, calcitriol, and calcium and iron supplements. He denied using alcohol, tobacco, or illicit drugs. He lives in Chicago and denies a recent travel history. His family history was significant for type 2 diabetes in multiple family members.The absence of drugs, tobacco, and alcohol lowers the risk of some infectious and ischemic conditions. Patients with alcoholic liver disease who live in the southern United States are predisposed t...

show abstract

Treatment and Outcomes of Diabetic Muscle Infarction

Abstract: This study supports the use of nonsurgical treatment in patients with DMI. It also demonstrates that DMI can be temporally associated with death.

Cited by 74 publications

References 38 publications

Diabetic Myonecrosis Mimicking Acute Compartment Syndrome of the Thigh

Diabetic Myonecrosis Mimicking Acute Compartment Syndrome of the Thigh

Myopathies due to Systemic Disease

A sheep in wolf's clothing

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