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Emergency Medicine Journal 2007;24:513-514; doi:10.1136/emj.2006.040071
© 2007 BMJ Publishing Group Ltd and the College of Emergency Medicine.

EMERGENCY CASEBOOK

Diabetic muscle infarction

Antony Mathew1, I Sreenath Reddy2, Colin Archibald2

1 Princess of Wales Hospital, Bridgend, UK
2 Royal Berkshire Hospital, Reading, UK

Correspondence to:
Correspondence to:
Antony Mathew
Emergency Unit, University Hospital of Wales, Cardiff, UK; AntonyMat{at}aol.com

ABSTRACT

Diabetic muscle infarction (DMI) is a rare complication of longstanding, poorly controlled diabetes. Only a few cases have been reported in the literature. The case of a 34-year-old man with a 7-year history of type 2 diabetes mellitus, with sudden onset of left thigh pain, is described here. A final diagnosis of DMI was made, the pathophysiology of which remains unclear. MRI findings were diagnostic and characteristic. The management of this condition is usually symptomatic. Short-term prognosis is very good; however, the recurrence rate is high. Long-term prognosis is poor, with most patients dying from cardiovascular complications of diabetes within 5 years of diagnosis. This case supports the need for a high index of suspicion, when a poorly controlled patient with diabetes presents with non-traumatic limb pain.

Abbreviations: DM, diabetes mellitus; DMI, diabetic muscle infarction; ED, emergency department; US, ultrasound


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