Diabetic Myonecrosis (Diabetic Muscle Infarction)

 • Spontaneous ischemic necrosis of skeletal muscle (anterior thigh or calf)

 • Rare complication of longstanding uncontrolled diabetes mellitus

 • Microvascular endothelial damage → tissue ischemia → necrosis

 • Suspect in diabetic pt with sudden onset muscle swelling & pain

 • Mean AIC: 9.3% with other diabetic complications

 • Common pattern: ↑CK, ↑ESR, ↑CRP

 • Diagnosis: MRI ↑signial intensity with inflammatory changes & edema

 • Tx: rest, analgesia (low dose ASA & NSAIDS), glycemic control (not surgery)

 • Average recovery 5.5 weeks with above treatment

 • High recurrence 35-48% in contralateral limb within 6 months



- CMC IM Residency @CMC_IM



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