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Diabetic Muscle Infarction: A Missed Diagnosis and Complication of a Common Disease

Ihsan Al-Bayati, Salman Otoukesh, Francisco T. Fernandez, Mona Mojtahedzadeh, Sarah Al-Obaidi, Mohamad Nawar Hakim, Harry E. Davis

(Department of Internal Medicine, Texas Tech University Health Science Center, Paul L. Foster School of Medicine, El Paso, TX, USA)

Med Sci Case Rep 2014; 1:50-53

DOI: 10.12659/MSCR.893108


Background: Diabetic muscle infarction is a rare complication and often missed diagnosis of long-standing and/or poorly controlled diabetes mellitus. It can be easily missed or treated mistakenly as infection. When it is suspected, other conditions in the differential diagnosis like pyomyositis/dermatomyositis, necrotizing fasciitis, tumors, and venous thrombosis should be investigated.
Case Report: We present a case of a 43-year-old Hispanic man who was complaining of progressive left thigh pain and swelling of 1-month duration. MRI suggested muscle infarction and muscle biopsy showed coagulative necrosis, which confirmed the diagnosis.
Conclusions: Diabetic muscle infarction needs to be considered as a differential diagnosis in patients presenting with muscle pain and swelling, especially given the global increase in the prevalence of diabetes. MRI with or without muscle biopsy is the test of choice for detection.

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