Diabetic muscle infarction: radiologic evaluation.
OBJECTIVE
Diabetic muscle infarction (DMI) is frequently misdiagnosed clinically as abscess, neoplasm, or myositis, and is often biopsied. Clinical and radiologic findings are presented here to enable the radiologist to suggest the correct diagnosis.


METHODS
Four patients with severe diabetes mellitus presenting with acute thigh pain, tenderness, and swelling were evaluated by imaging techniques and biopsy.


CONCLUSIONS
Edema in the affected muscles was seen in two patients with MRI studies. Femoral artery calcification and mild muscle swelling was present in one patient who underwent CT. Decreased echogenicity was seen in the involved muscle in a patient studied with ultrasound. Serum enzymes were normal or mildly elevated in three patients (not reported in one). Biopsy demonstrated necrosis and regenerative change in all cases. MRI, although nonspecific, is the best imaging technique to suggest the diagnosis of DMI in the appropriate clinical setting, thereby obviating biopsy.
Chason
D P
DP
Algur H. Meadows Diagnostic Imaging Center, University of Texas, Southwestern Medical Center, Dallas 75235-8896, USA.
Fleckenstein
J L
JL
Burns
D K
DK
Rojas
G
G
D000328:Adult; D001706:Biopsy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007238:Infarction / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000473:pathology; D013848:Thigh