Abstract
Diabetic muscle infarction is a rare complication of diabetes mellitus that presents as a localized, exquisitely painful swelling and limited range of motion of the involved extremity. The onset is usually acute, persists for several weeks and resolves spontaneously over several weeks to months without the need for intervention. However, as diabetes mellitus is an immunocompromised state and any painful swelling in the limbs is often taken as infectious in aetiology, the patient is inadvertently investigated with invasive procedures and is started on unnecessary antibiotics, adding to the burden of management. Keeping in view the low threshold for starting antibiotics in painful limb swelling in diabetes mellitus in our setting, we hereby describe a case of recurrent painful diabetic muscle infarction, first involving the right upper and later the right lower limb, managed with physical rest and analgesics. This case emphasizes that the treating physician keep this rare complication of diabetes mellitus in consideration in the respective clinical scenario and adopt a less aggressive (a noninvasive method like ultrasound) rather than a more aggressive (an invasive method like muscle biopsy) approach in diagnosis and take a similar approach towards management.
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Trujillo-Santos AJ. Diabetic muscle infarction: an under diagnosed complication of long standing diabetes. Diabetes Care 2003; 26: 211–215.
Rocca PV, Alloway JA, Nashel DJ. Diabetic muscle infarction. Semin Arthritis Rheum 1993; 22:280–287.
Umpierrez GE, Stiles RG, Kleinbart J, Krendel DA, Watts NB. Diabetic muscle infarction. Am J Med 1996; 101:245–250.
Kapur S, Brunet JA, Mc Kendry RJ. Diabetic muscle infarction: case report and review. J Rheumatol 2004; 31:190–194.
Salehi P, Stull MA, Martelloto J, Gangemi A, Hatipoglu B, Benedetti E, Oberholzer J, et al. Case report: diabetic myonecrosis of the neck complicated by infection in an islet transplanted patient. J Diab Complications 2009; 23:140–142.
Angerall L, Stener B. Tumoriform focal muscular degeneration in two diabetic patients. Diabetologia 1965; 1:39–42.
Banker BQ, Chester CS. Infarction of thigh muscle in the diabetic patient. Neurology 1973; 23:667–677.
Chester CS, Banker BQ. Focal infarction of muscle in diabetics. Diabetes Care 1986; 9:623–630.
Silberstein L, Britton KE, Marsh FP, Roftery MJ, D’Cruz D. An unexpected cause of muscle pain in diabetes. Ann Rheum Dis 2001; 60:310–312.
Delaney-Sathy LO, Fessell DP, Jacobson JA, Hayes CW. Sonography of diabetic muscle infarction with MR Imaging, CT and pathologic correlation. Am J Roentgenol 2000; 174:165–169.
Jelinek JS, Murphey MD, Aboulafia AJ, Dussault RG, Kaplan PA, Snearly WN. Muscle infarction in patients with diabetes mellitus: MR imaging findings. Radiology 1999; 211:241–247.
Grigoriadis E, Fam AG, Starok M, Ang LC. Skeletal muscle infarction in diabetes mellitus. J Rheumatol 2000; 27:1063–1068.
Angervall L, Stener B. Tumoriform focal muscular degeneration in two diabetic patients. Diabetologia 1965; 1:39–42.
Barohn RJ, Kissel JT. Case-of-the-month: painful thigh mass in young women: diabetic muscle infarction. Muscle Nerve 1992; 15: 850–855.
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Bhat, T., Naik, M., Farooq Mir, M. et al. Recurrent diabetic muscle infarction, a rare complication of diabetes: a case report. Egypt Rheumatol Rehabil 44, 181–184 (2017). https://doi.org/10.4103/1110-161X.217439
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DOI: https://doi.org/10.4103/1110-161X.217439