Abstract
Diabetic mellitus (DM) has many well-known complications. However, there is one rare complication, diabetic muscle infarction (DMI), which is usually under diagnosed. Hereby, we present a 53-year-old Chinese man with a history of DM, hypertension and atrial fibrillation. He had acute onset of severe left lower leg pain and swelling with difficulty in walking 4 days before admission. Physical examination revealed non-pitting and non-erythematous swelling with cold sensation of the left medial calf muscles. Magnetic resonance image (MRI) showed homogenous high signal changes in the calf muscles on T2 images, which indicated DMI. After anticoagulation treatment, the patient had a fair recovery within 4 weeks and he could walk by himself thereafter. DMI is a rare complication of poorly controlled DM. It does have a characteristic clinical presentation and MRI findings. Increased clinical awareness is important for early recognition and correct treatment.
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References
Angervall L, Stener B (1965) Tumoriform focal muscular degeneration in two diabetic patients. Diabetologia 1:39–42
Grigoriadis E, Fam AG, Starok M, Chyang L (2000) Skeletal muscle infarction in diabetes mellitus. J Rheumatol 27:1063–1068
Ly JQ, Yi EK, Beall DP (2003) Diabetic muscle infarction. AJR 181:1216
Aboulafia AJ, Monson DK, Kennon RE (1999) Clinical and radiological aspects of idiopathic diabetic muscle infarction. J Bone Joint Surg 81-B:323–326
Trujillo-Santos AJ (2003) Diabetic Muscle Infarction—an underdiagnosed complication of long-standing diabetes. Diabetes Care 26:211–215
Jelinek JS, Murphey MD, Aboulafia AJ, Dussault RG, Kaplan PA, Snearly WN (1999) Muscle infarction in patients with diabetes mellitus: MR imaging findings. Radiology 211:241–247
Umpierrez GE, Stiles RG, Kleinbart J, Krendel AD, Watts NB, Georgia A (1996) Diabetic muscle infarction. Am J Med 101:245–250
Kapur S, Brunet JA, McKendry RJ (2004) Diabetic muscle infarction: case report and review. J Rheumatol 31:190–194
Naderi ASA, Farsian FN, Palmer BF (2008) Diabetic muscle necrosis. J Diabetes Complications 22:150–152
Bjornskov EK, Carry MR, Katz FH, Lefkowitz J, Ringel SP (1995) Diabetic muscle infarction: a new perspective on pathogenesis and management. Neuromus Disord 5:39–45
Mohammed A, Hamilton D, Wong K (2006) Recurrent muscle infarction in a diabetes patient. N Z Med J 119:1238–1242
Palmer GW, Greco TP (2001) Diabetic thigh muscle infarction in association with antiphopholipid antibodies. Semin Arthritis Rheum 30:272–280
Miller JM, Fleckenstein J, Nodera H, Herrmann DN (2003) MRI in diabetic muscle infarction. Neurology 60:1019
Scully RE, Mark EJ, McNeely WF, Ebeling SH, Philips LD (1997) Weekly clinicopathological exercises. N Engl J Med 337(12):839–845
Kapur S, McKendry RJ (2005) Treatment and outcomes of diabetic muscle infarction. J Clin Rheumatol 11:8–12
Baumgartner I, Isner JM (2001) Somatic gene therapy in the cardiovascular system. Annu Rev Physiol 63:427–450
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E. Huang and C.-F. Ho have equal contributions to this article.
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Huang, E., Ho, CF., Yip, PK. et al. Diabetic muscle infarction in a patient with acute embolic stroke. Neurol Sci 31, 345–347 (2010). https://doi.org/10.1007/s10072-009-0191-y
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DOI: https://doi.org/10.1007/s10072-009-0191-y