Clinical and radiological aspects of idiopathic diabetic muscle infarction

Abstract

T he systemic effects of diabetes mellitus are well recognised. The heart, kidney, central and peripheral nervous systems, and the distal parts of the limbs are often the site of end-organ damage resulting from ischaemia. Infarction of large muscle groups in the limb, not associated with gangrene, is uncommon. There have been few reported cases other than radiological descriptions of diabetic muscle infarcts. While previous reports have illustrated some of the clinical and radiological characteristics of this condition, the paucity of published cases makes it difficult to determine the most appropriate methods of diagnosis and treatment.During a five-year period we treated 14 patients with diabetes mellitus, aged from 32 to 59 years, who were referred to a musculoskeletal oncology service for suspected soft-tissue sarcoma, but were subsequently found to have a diabetic muscle infarct. Closed needle biopsy was performed in 13 without complications. In 12 patients, the symptoms resolved without surgical treatment.

Diabetic Muscle Infarction of the Peroneus Brevis: A Case Report

“…It reveals swollen and oedematous muscles under increased signal intensity of T2-weighted images. 6,7 Ultrasound findings of this patient also revealed typical diabetic muscle infarction, namely a well-marginated, hypo-echoic, and intramuscular lesion with features of internal linear echogenic structures coursing through the lesion, an absence of internal motion or swirling of fluid transducer pressure, and a lack of a predominantly anechoic area. These findings may help to differentiate diabetic muscle infarction from a necrotic mass or abscess.…”

Muscle compromise in diabetes

“…While anticoagulants, antiphospholipid antibodies, and steroids have been used, conservative treatment is favored for DMI, with bed rest, analgesics, physiotherapy, and gradual mobilization (7,29,30). Complete resolution may take weeks to a few months, although relapses may occur.…”