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Diabetic muscle infarction: often misdiagnosed and mismanaged

 

Authors Verjee MA, Abdelsamad NA, Qureshi S, Malik RA

Received 8 October 2018

Accepted for publication 16 January 2019

Published 5 March 2019 Volume 2019:12 Pages 285—290

DOI https://doi.org/10.2147/DMSO.S185839

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Ming-Hui Zou

Abstract: A patient with type 2 diabetes, retinopathy, neuropathy, and nephropathy presented with severe right distal thigh pain, which awoke him from sleep. He was diagnosed with musculoskeletal pain and discharged home. Two days later, the severity of pain increased in his right thigh and, subsequently, he developed pain in the proximal lateral aspect of his left thigh, for which he returned to hospital. He had elevated creatine kinase and myoglobin levels. An ultrasound of the right thigh identified a loss of definition of the normal muscular striations and subcutaneous edema. On MRI, the axial STIR image demonstrated extensive T2 hyperintensity in the right vastus medialis  and left vastus lateralis , consistent with the diagnosis of diabetic muscle infarction (DMI). This presentation emphasizes the need for a thorough patient history and physical examination, and the importance of directed imaging for the prompt diagnosis of DMI.
Keywords: muscle infarction, edema, microvascular, nephropathy, neuropathy, retinopathy, striations


 

摘要视频链接:Diabetic muscle infarction