Diabetic myonecrosis

Case contributed by Dr Eric F Greif

Presentation

New onset severe right thigh pain and mild swelling. Diabetic patient.

Patient Data

Age: 71
Gender: Male
MRI

T2-weighted images show extensive intramuscular edema within the vastus lateralis and adductor magnus muscle groups. Diffuse fascial edema and subcutaneous soft-tissue edema is also noted within these muscle groups. T1-weighted, postcontrast images showed areas of muscle necrosis within the vastus lateralis muscle.

No evidence for abscess formation or osteomyelitis.

Case Discussion

Patient is an uncontrolled diabetic, who presented with acute onset right thigh pain. Patient labs (elevated): myoglobin= 126 NG/ml CPK= 1,033 IU/L and Lactic acid= 4.0 mmol/L, HA1c= 15%. Findings are consistent for diabetic myonecrosis.

 Differentials may include (if not given history/labs):  infectious myositis and rhabdomyolysis.

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Case information

rID: 32710
Case created: 10th Dec 2014
Last edited: 7th Oct 2015
Inclusion in quiz mode: Included

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