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Mukherjee S, Aggarwal A, Rastogi A, et al. Spontaneous diabetic myonecrosis: report of four cases from a tertiary care institute. Endocrinol Diabetes Metab Case Rep. 2015;2015:150003doi: 10.1530/EDM-15-0003.
Mukherjee, S., Aggarwal, A., Rastogi, A., Bhansali, A., Prakash, M., Vaiphei, K., & Dutta, P. (2015). Spontaneous diabetic myonecrosis: report of four cases from a tertiary care institute. Endocrinology, diabetes & metabolism case reports, 2015150003. https://doi.org/10.1530/EDM-15-0003
Mukherjee, Soham, et al. "Spontaneous diabetic myonecrosis: report of four cases from a tertiary care institute." Endocrinology, diabetes & metabolism case reports vol. 2015 (2015): 150003. doi: https://doi.org/10.1530/EDM-15-0003
Mukherjee S, Aggarwal A, Rastogi A, Bhansali A, Prakash M, Vaiphei K, Dutta P. Spontaneous diabetic myonecrosis: report of four cases from a tertiary care institute. Endocrinol Diabetes Metab Case Rep. 2015;2015:150003. doi: 10.1530/EDM-15-0003. Epub 2015 May 01. PMID: 26124952; PMCID: PMC4482157.
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Endocrinol Diabetes Metab Case Rep. 2015;2015:150003. doi: 10.1530/EDM-15-0003. Epub 2015 May 01.

Spontaneous diabetic myonecrosis: report of four cases from a tertiary care institute.

Endocrinology, diabetes & metabolism case reports

Soham Mukherjee, Anuradha Aggarwal, Ashu Rastogi, Anil Bhansali, Mahesh Prakash, Kim Vaiphei, Pinaki Dutta

Affiliations

  1. Department of Endocrinology , Post Graduate Institute of Medical Education and Research , Chandigarh, 160012 , India.
  2. Department of Radiology , Post Graduate Institute of Medical Education and Research , Chandigarh, 160012 , India.
  3. Department of Histopathology , Post Graduate Institute of Medical Education and Research , Chandigarh, 160012 , India.

PMID: 26124952 PMCID: PMC4482157 DOI: 10.1530/EDM-15-0003

Abstract

UNLABELLED: Spontaneous diabetic muscle infarction (DMI) is a rare and under diagnosed complication of diabetes mellitus. Clinically it presents with acute to subacute onset swelling, pain and tenderness of muscle(s) without systemic manifestations. MRI is helpful in diagnosis, exclusion of other causes and for localization of affected muscle for biopsy in atypical cases. Muscles of the thighs are commonly affected in diabetic myonecrosis (DMN). Here we present the summary of four cases seen in the last 3 years in a tertiary care centre with simultaneous or sequential involvement of multiple groups of muscles or involvement of uncommon sites. All these patients had advanced duration of diabetes with microvascular complications and poor glycemic control. Conservative management including rest and analgesics is the treatment of choice. Short-term prognosis is good but there may be recurrence.

LEARNING POINTS: A high index of suspicion is required for the diagnosis of DMN which can avoid inadvertent use of antibiotics.Acute-subacute onset severe focal muscle pain in the absence of systemic symptoms in a female patient with long-standing diabetes with microvascular complications suggests DMI.MRI is the most sensitive test for diagnosis.Muscle biopsy should be reserved for atypical cases.Conservative management including rest and analgesics has good outcome.Improvement usually occurs within 6-8 weeks, but there may be recurrence.

References

  1. Radiology. 1999 Apr;211(1):241-7 - PubMed
  2. J Clin Rheumatol. 2005 Feb;11(1):8-12 - PubMed
  3. Case Rep Endocrinol. 2013;2013:190962 - PubMed
  4. Semin Arthritis Rheum. 2001 Feb;30(4):272-80 - PubMed
  5. J Community Hosp Intern Med Perspect. 2013 Apr 17;3(1):null - PubMed
  6. Endocr Pract. 2002 Sep-Oct;8(5):343-6 - PubMed
  7. Diabetes Care. 2003 Jan;26(1):211-5 - PubMed
  8. J Clin Invest. 2007 May;117(5):1219-22 - PubMed
  9. Am J Emerg Med. 2008 Oct;26(8):969.e3-4 - PubMed
  10. Iowa Orthop J. 2000;20:65-74 - PubMed
  11. Indian J Med Sci. 2011 Jul;65(7):311-5 - PubMed
  12. Case Rep Endocrinol. 2011;2011:624020 - PubMed

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