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Diabetic Myonecrosis: Lessons in Recognizing and Treating a Rare Complication
Brandon Garten1, Mark Schwade1, Saleh Alkathiri1
1Medical College of Georgia, Augusta University, USA.
Journal of Investigative Medicine High Impact Case Reports
|March 31, 2025
Summary
Diabetic myonecrosis, a rare diabetes complication causing limb pain, can be misdiagnosed. Prompt MRI diagnosis and treatment with aspirin, insulin, and pain management improved patient outcomes.
Area of Science:
- Endocrinology
- Diabetology
- Musculoskeletal Medicine
Background:
- Diabetic myonecrosis is a rare, often misdiagnosed, complication of poorly controlled diabetes.
- It presents with spontaneous limb pain and swelling, mimicking infectious or vascular issues.
- Associated with microvascular complications like nephropathy and retinopathy.
Purpose of the Study:
- To present a case of diabetic myonecrosis in a patient with type 2 diabetes.
- To highlight the diagnostic challenges and successful management strategies.
- To emphasize the need for prompt diagnosis and further research.
Main Methods:
- Case report of a 49-year-old male with type 2 diabetes and recurrent thigh pain.
- Initial misdiagnosis as cellulitis, treated with antibiotics without improvement.
- Diagnosis confirmed by Magnetic Resonance Imaging (MRI).
Main Results:
- The patient experienced persistent severe pain despite antibiotic treatment.
- MRI confirmed diabetic myonecrosis.
- Successful management with aspirin, insulin therapy, and multimodal pain regimen led to significant improvement.
Conclusions:
- Diabetic myonecrosis presents a diagnostic challenge due to rarity and nonspecific symptoms.
- Prompt diagnosis via exclusionary testing and imaging is crucial.
- Effective management can prevent severe complications, but standardized protocols are needed.
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