Diabetic muscle infarction: Often misdiagnosed and mismanaged

Mohamud A. Verjee, Nael Amin Abdelsamad, Salman Qureshi, Rayaz Malik

Research output: Contribution to journalArticle

Abstract

A patient with type 2 diabetes, retinopathy, neuropathy, and nephropathy presented with severe right distal thigh pain, which awoke him from sleep. He was diagnosed with musculoskeletal pain and discharged home. Two days later, the severity of pain increased in his right thigh and, subsequently, he developed pain in the proximal lateral aspect of his left thigh, for which he returned to hospital. He had elevated creatine kinase and myoglobin levels. An ultrasound of the right thigh identified a loss of definition of the normal muscular striations and subcutaneous edema. On MRI, the axial STIR image demonstrated extensive T2 hyperintensity in the right vastus medialis and left vastus lateralis, consistent with the diagnosis of diabetic muscle infarction (DMI). This presentation emphasizes the need for a thorough patient history and physical examination, and the importance of directed imaging for the prompt diagnosis of DMI.

Original languageEnglish
Pages (from-to)285-290
Number of pages6
JournalDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Volume12
DOIs
Publication statusPublished - 1 Jan 2019

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Keywords

  • Edema
  • Microvascular
  • Muscle infarction
  • Nephropathy
  • Neuropathy
  • Retinopathy
  • Striations

ASJC Scopus subject areas

  • Internal Medicine
  • Pharmacology

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