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Diabetic muscle infarction

G E Umpierrez1, R G Stiles, J Kleinbart

  • 1Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30303, USA.

The American Journal of Medicine
|September 1, 1996
PubMed
Summary

Diabetic muscular infarction (DMI) is a rare diabetes complication presenting as abrupt thigh pain. Magnetic resonance imaging (MRI) and clinical findings aid diagnosis, often avoiding invasive biopsies.

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Area of Science:

  • Endocrinology
  • Neurology
  • Radiology

Background:

  • Diabetic muscular infarction (DMI) is a rare complication of diabetes mellitus.
  • It typically affects patients with long-standing insulin-dependent diabetes and microvascular complications.

Observation:

  • DMI presents with abrupt onset of thigh pain, tenderness, and a palpable mass.
  • Affected muscles include thigh adductors, vastus lateralis, and biceps femoris.
  • Lesions resolve spontaneously over weeks to months, with recurrence in half of patients.

Findings:

  • Magnetic resonance (MR) imaging, particularly T2-weighted sequences, sensitively detects active muscle pathology.
  • Histology shows muscle necrosis and edema, with regenerating fibers and lymphocytic infiltration.
  • Diagnosis is often achievable through characteristic clinical presentation and MR imaging.

Implications:

  • Awareness of DMI and prompt MR imaging can lead to accurate diagnosis and reduced hospitalization.
  • This approach may help avoid unnecessary invasive procedures like muscle biopsy.
  • Understanding DMI's clinical and imaging features is crucial for diabetic patients with unexplained leg pain.

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