Diabetic muscle infarction

doi:10.1136/bmj.b2271

Published 19 June 2009, doi:10.1136/bmj.b2271
Cite this as: BMJ 2009;338:b2271

Practice

Lesson of the week

Diabetic muscle infarction

Malvinder S Parmar, associate professor, division of clinical sciences

¹ Northern Ontario School of Medicine, Laurentian and Lakehead Universities, Ontario, Canada

Correspondence to: M S Parmar, Medical Office Building, Timmins and District Hospital, Suite E, 640 Ross Ave East, Timmins, ON, P4N 8P2, Canada atbeat@ntl.sympatico.ca

Timely diagnosis of diabetic muscle infarction helps preventcomplications in a patient presenting with painful swollen extremity

The first 150 words of the full text of this article appear below.

Diabetic muscle infarction is a rare complication of diabetesthat occurs in patients with type 1 diabetes (70% of total cases)or in patients with poorly controlled type 2 diabetes.¹ It presentswith sudden onset of a painful swelling, often of the thigh,which is bilateral in up to a third of patients, and it occursspontaneously without a history of trauma or features of infection.²Diabetic muscle infarction is under-recognised and often misdiagnosed,³⁴ and treated as rhabdomyolysis or polymyositis. A high indexof suspicion is needed to make a timely diagnosis and to avoidthe use of steroids or surgical intervention. This report highlightsthe clinical investigations, laboratory tests, and imaging scansneeded to establish the clinical diagnosis in a timely fashionto avoid unnecessary and possibly harmful interventions.