Diabetic Muscle Infarction
Myocardial infarct equivalent
- Kai Ming Chow, MRCP1,
- Cheuk Chun Szeto, MRCP, MD1,
- Teresa Yuk-hwa Wong, MRCP1,
- Franky Kay-tai Leung, MRCP2,
- Au Cheuk, MRCP3 and
- Philip Kam-tao Li, FRCP, FACP1
- 1Department of Medicine & Therapeutics, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
- 2Department of Medicine & Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, SAR, China
- 3Department of Medicine & Geriatrics, Princess Margaret Hospital, Hong Kong, SAR, China
Diabetic muscle infarction (DMI) is a serious complication seen in patients with long-standing diabetes. Evidence is accumulating since the first description of this entity in 1965 (1). Increasing awareness has led to prompt recognition of this previously underdiagnosed condition. Typically, acute presentation with atraumatic painful swelling, notably of the quadriceps or thigh muscles, is found in diabetic subjects with established vasculopathy including retinopathy and nephropathy. Laboratory investigations generally show high erythrocyte sedimentation rate, normal white cell count, and normal or mild elevation of creatine phosphokinase. Magnetic resonance imaging (MRI) findings are invariably characterized by increased signal intensity of the diffusely enlarged muscle groups on T2-weighted sequences, inversion-recovery, and gadolinium-enhanced images (2–4). The disease is generally believed to be self-limiting, although recurrence can occur in half of the cases (4,5).
We have previously reported two …
