Diabetic myonecrosis

Case contributed by Eric F Greif


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

Patient Data

Age: 71
Gender: Male

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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