Diabetic myonecrosis in an orthotopic heart transplant recipient

Diabetic myonecrosis or muscle infarction (DMI) is a rare cause of lower extremity pain that usually occurs in patients with poorly controlled diabetes. Although most patients recover with opiate analgesics and anti-inflammatory medications, this type of myonecrosis is associated with the presence of serious vascular disease. Consideration of this diagnosis and use of soft-tissue imaging are especially important in diabetic organ transplant recipients to prevent erroneous treatment for presumed infection. We describe what we believe is the first reported case of diabetic myonecrosis occurring in a patient with iatrogenically induced diabetes after orthotopic heart transplantation.