A rare complication of diabetes mellitus in a 65-year-old man
Section snippets
Case
A 65-year old man is admitted to the hospital, complaining of left thigh pain of 2-day duration. The pain gets worse with activity. He denies lower limb erythema, fevers, chills, weight loss, calf tenderness or swelling. There is no history of trauma or skin rash. His medical history is significant for obstructive sleep apnea and Type 2 diabetes mellitus for 12 years that is complicated by retinopathy. He takes insulin for the treatment of his diabetes but has poor glycemic control and
Discussion
Spontaneous diabetic myonecrosis is a rare and unusual complication of long-standing diabetes mellitus. It was first described in 1965 by Angervall and Stener (Angervall & Stener, 1965). There was delay in diagnosis because of failure to recognize it (Buckingham et al., 1995). Most of the patients are on insulin treatment and have poor glycemic control. It is more common in female, with female-to-male ratio of 1.7:1 (Umpierrez et al., 1996). Most of the patients who develop this condition have
Conclusion
Spontaneous diabetic myonecrosis is a rare and uncommon complication of diabetes mellitus. The patient presents with abrupt, swollen leg that might mimic deep vein thrombosis. There might be delay in the diagnosis because of the rarity of the disease. MRI help in the diagnosis and the biopsy are the gold standard for diagnosing spontaneous diabetic myonecrosis. Treatment is supportive. It is very important for the patient to have a good glycemic control to avoid complications of diabetes and to
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