Diabetic muscle infarction.
Diabetic muscle infarction is a rare complication of diabetes mellitus that is not clearly defined in the orthopaedic literature. This study is a descriptive case series of 7 new cases of diabetic muscle infarction and 55 previously reported cases in the literature. In the majority of patients, diabetic muscle infarction presents as a localized, exquisitely painful swelling and limited range of motion of the lower extremity. No cases affecting the muscles of the upper extremity have been observed. The onset is usually acute, persists for several weeks, and resolves spontaneously over several weeks to months without the need for intervention. Diabetic muscle infarction is a condition that should be considered in the differential diagnosis of any diabetic patient with lower extremity pain and swelling without systemic signs of infection. Magnetic resonance imaging is sensitive and specific enough to make the diagnosis. Muscle biopsy and surgical irrigation and debridement are not recommended since they are associated with complications. Pain management and activity restriction in the acute phase followed by gentle physical therapy is the treatment of choice. Recurrences in the same or opposite limb are common. Although the short-term prognosis is very good and the majority of cases resolve spontaneously, the long-term survival is uncertain in this patient population.
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242, USA. jose-morcuende@uiowa.edu
J A
JA
Morcuende
M B
MB
Dobbs
H
H
Crawford
J A
JA
Buckwalter
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D048909:Diabetes Complications; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007238:Infarction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000098:blood supply*; D010146:Pain / Q000209:etiology; D026741:Physical Therapy Modalities; D011379:Prognosis; D016059:Range of Motion, Articular; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012680:Sensitivity and Specificity