[Painful syndromes in diabetic patients due to skeletal muscle injuries].
Progressive painful syndromes due to skeletal muscle injuries rather than diabetic neuropathy are unusual complications of diabetes mellitus (DM). Two clinical cases are presented: Case 1 (pyomyositis: leg location) and Case 2 (muscle infarction: thigh location). Discussion on how to proceed the diagnosis based on clinical features are included as it is critical for early and proper treatment since approaches highly differ in the two situations. These complications can mimic thrombophlebitis, rhabdomyolyses or a neoplasm, therefore the diagnosis of a diabetes-related disorder may be overlooked. If pyomyositis is not correctly treated with antibiotics and in some cases with surgery, systemic infection and even death may occur, whereas muscle infarction only requires rest and analgesia. Image and laboratory investigations can be of help to differentiate these syndromes, although some findings can overlap. Thus, the present report emphasizes the importance to include these diseases when limb painful syndromes are to be investigated in a diabetic patient.
Pereira
Flávia O
FO
Serviço de Endocrinologia, Hospital Celso Ramos, Departamento de Farmacologia, Universidade Federal de Santa Catarina, Florianópolis, SC. fopereira@gmail.com
Medeiros
Yara S
YS
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology; D016883:Diabetic Ketoacidosis / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007238:Infarction / Q000209:etiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000473:pathology; D010146:Pain / Q000209:etiology / Q000473:pathology*; D052880:Pyomyositis / Q000209:etiology / Q000473:pathology*; D013577:Syndrome