Diabetic Muscle Infarction: A Rare End-Organ Vascular Complication of Diabetes

Abstract

Diabetic muscle infarction (DMI) is a rare microvascular complication of spontaneous ischemic necrosis of skeletal muscle in patients with poorly controlled diabetes. We herein describe the case of a 26-year-old woman with a history of type I diabetes and accompanying diabetic microvascular complications of neuropathy, nephropathy and retinopathy, who presented with sudden onset of swelling and sharp pain in her bilateral thighs. T2-weighted MRI imaging revealed subcutaneous edema and sub-fascial, hyper-intense enhancement of proximal thigh musculature. DMI has a relatively non-specific clinical presentation; therefore, physician awareness is key for early diagnosis, as aggressive management has been associated with poor patient outcomes. With poor long-term prognosis and high reoccurrence, DMI acts as an indicator of vascular end-organ damage.

Diabetic ketoacidosis and unilateral thigh pain

“…Most patients die within 2-5 years of diagnosis from macrovascular disease. 5 DLRPN predominantly affects older patients with type 2 DM. It presents with severe unilateral thigh pain, wasting, progressive weakness and marked weight loss.…”