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Diabetic Muscle Infarction Treatment

Diabetic Muscle Infarction: A Rare Complication Of Long-standing And Poorly Controlled Diabetes Mellitus

Diabetic Muscle Infarction: A Rare Complication Of Long-standing And Poorly Controlled Diabetes Mellitus

Diabetic Muscle Infarction: A Rare Complication of Long-Standing and Poorly Controlled Diabetes Mellitus Shridhar N. Iyer ,1 Almond J. Drake III ,2 R. Lee West ,3and Robert J. Tanenberg 2 1Division of General Internal Medicine, Department of Internal Medicine, The Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA 2Division of Endocrinology, Department of Internal Medicine, The Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA 3Department of Pathology, The Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA Received 9 July 2011; Accepted 8 August 2011 Copyright 2011 Shridhar N. Iyer et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To report a case of diabetic muscle infarction (DMI), a rare complication of long-standing poorly controlled diabetes mellitus. Methods. We describe a case of a 45-year-old male with an approximately 8-year history of poorly controlled type 2 diabetes mellitus with multiple microvascular complications who presented with the sudden onset of left thigh pain and swelling. He had a swollen left thigh and a CK of 1670 U/L. He was initially treated with intravenous antibiotics for a presumptive diagnosis of pyomyositis or necrotizing fasciitis with no improvement. A diagnosis of diabetic muscle infarction was considered. Results. An MRI of the thigh demonstrated diffuse edema in the anterior compartment. A muscle biopsy demonstrated coagulation necrosis in skeletal muscle and inflammation and infarction in the walls of small blood vessels. These studies confirmed the final diagnosis of D Continue reading >>

Diabetic Muscular Infarction

Diabetic Muscular Infarction

Dr. Marinescu is a Senior Rheumatology Fellow, Albert Einstein College of Medicine, New York. Diabetic muscular infarction, or DMI, was once considered an extremely rare complication of diabetes. Today, now that we can use non-invasive MRI imaging to detect DMI very easily — rather than using a muscle biopsy, the old way — we know that the condition is more common than previously thought, though still fairly rare. Because its symptoms can be easy to miss, DMI is often not noticed or treated as quickly as it should be. Anyone who has diabetes or who has a loved one with the disease should be aware of the possibility of developing DMI. If you suspect that you or a loved one might have DMI, then you should seek immediate medical attention. Diabetic muscular infarction causes a sore, painful area in a muscle, usually a thigh muscle; it is called diabetic because it is caused by circulation problems that are the result of long-term diabetes. Infarction is a medical condition in which tissue dies because its blood supply is cut off. DMI sometimes occurs in the calf muscles (19% of all cases). It is most common in people who have lived for years with type 1 diabetes (which typically is childhood diabetes and requires insulin) and who have poor glycemic control; that is, for whatever reason, they have not been able to keep their blood sugar levels under control. Women are more likely than men to get DMI. Most of the patients with DMI have diabetes-related damage to other organs as well, including the kidneys (71%), eyes (57%) and nerves (54.5%). Because its symptoms can be easy to miss, DMI is often not noticed or treated as quickly as it should be. DMI can come and go. It typically begins with muscle pain and swelling. After that, the pain partially subsides and a tender m Continue reading >>

Non-traumatic Muscle Pain In A Diabetic

Non-traumatic Muscle Pain In A Diabetic

Monalisa Mullick, MD¹, Cheryl McDonough, MD² INTRODUCTION The prevalence of diabetes in the adult population in United States is approximately 10% and is expected to rise. The myriad of complexities of this entity, both microvascular and macrovascular is anticipated to follow suit, adding to the morbidity and mortality. Diabetic muscle infarction (DMI) is one such incompletely understood complication of long-standing uncontrolled diabetes and seems to play a crucial role in risk stratification in those with microvascular involvement. DMI has shown to be a poor prognosticator of long-term survival, a grim reality given the mean age of presentation is only 43 years. Further investigation into improving this outlook and whether tighter glycemic control changes outcome would be of significant interest and benefit. CASE PRESENTATION A 24-year-old male with hypertension and twenty-year history of uncontrolled type I diabetes was admitted with two months of pain near the right knee, acutely worsening over one week. Right knee effusion was recently diagnosed with synovial fluid twice negative for infection or crystals. He denied fever, chills, weight loss, trauma, injecting insulin in the area, or illicit drug use. Lower extremity paresthesias were chronic. He previously had a toe amputated due to osteomyelitis. On exam, he was afebrile. Right knee had a small effusion but was without associated redness or pain. An area of significant tenderness to palpation with no erythema, warmth, swelling, or mass was present on the right medial thigh just proximal to the knee. Electrolytes, renal function, leukocyte count and differential, and coagulation profile were normal. Blood glucose was 457 with glycosylated hemoglobin of 17. Synovial fluid was minimally inflammatory. Doppler was Continue reading >>

Retrospective Analysis Of Treatment Modalities In Diabetic Muscle Infarction.

Retrospective Analysis Of Treatment Modalities In Diabetic Muscle Infarction.

Retrospective analysis of treatment modalities in diabetic muscle infarction. Department of Medicine; Allergy/Immunology Rheumatology Division, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA. More 2.Department of Medicine; Allergy/Immunology Rheumatology Division, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA. Diabetic muscle infarction (DMI) is a spontaneous necrosis of skeletal muscle of unknown etiology. The major risk factor is longstanding uncontrolled diabetes mellitus (DM). Optimal treatment for DMI is not known. The purpose of this study was to analyze the outcome of surgical treatment, physiotherapy, and bed rest in DMI.We searched Medline from its inception to April 2013. We selected cases that provided sufficient data on recovery duration, recurrences, and non-recurrences. Baseline characteristics, including age, sex, microvascular complications, lesion size estimated on magnetic resonance imaging, type of diabetes, and duration of diabetes were assessed. The primary outcome was mean time to recovery from initial treatment and secondary outcomes were mean time to recurrence and recurrence rate.Mean time to recovery was 149 (95% confidence interval [CI] 113-186), 71 (95% CI 47-96), and 43 (95% CI 30-57) days for surgery, physiotherapy and bed rest, respectively. These figures were statistically significant only for surgery versus physiotherapy and surgery versus bed rest (P<0.01). Mean time to recurrence was 30, 107, and 297 days for surgery, physiotherapy, and bed rest, respectively. The recurrence rate was 57%, 44%, and 24% for surgery, physiotherapy, and bed rest, respectively.Our results show a similar outcome for physiotherapy as compared with bed rest. It also confirms nonsurgical treatment as a better therapeu Continue reading >>

Painful Legs In Diabetes! Check For Diabetic Muscle Infarction!

Painful Legs In Diabetes! Check For Diabetic Muscle Infarction!

Diabetic muscle infarction (DMI) is the muscle tissue damage due to diabetes. It is a medical condition in which tissue dies because its blood supply is cut off. It is a rare complication in patients with advanced diabetes mellitus (DM). Patients having diabetic nephropathy are prone to develop diabetic muscle infarction. It is caused by infarcted (tissue death due to inadequate blood supply to the affected area) muscle tissue, most commonly in the thigh. Nearly one-fourth of Diabetic muscle infarction patients receive renal replacement treatment. Because its symptoms can be easy to miss, DMI is often not noticed or treated as quickly as it should be. Anyone who has diabetes should be aware of the possibility of developing DMI. If you suspect that you might have DMI, then you should seek immediate medical attention. HOW IS THIS MUSCULAR INFARCTION RELATED TO DIABETES? Diabetic muscular infarction causes sore, painful area in a muscle, usually a thigh muscle. It is called diabetic because it is caused by circulation problems that are the result of long-term diabetes. DMI sometimes occurs in the calf muscles (19% of all cases). It is most common in people who have lived for years with type 1 diabetes (which typically is childhood diabetes and requires insulin) and who have poor glycemic control; that is, for whatever reason, they have not been able to keep their blood sugar levels under control. Women are more likely than men to get DMI. Most of the patients with DMI have diabetes-related damage to other organs as well, including kidneys, eyes and nerves. WHAT CAUSES DMI? Cause of DMI or how the disease progresses is not completely understood. While arteriosclerosis (hardening of the arteries) and diabetic microangiopathy, (damage to the small blood vessels caused by diab Continue reading >>

Painful Swelling Of The Thigh In A Diabetic Patient: Diabetic Muscle Infarction

Painful Swelling Of The Thigh In A Diabetic Patient: Diabetic Muscle Infarction

The occurrence of a painful, inflammatory swelling in a lower limb is consistent with several diagnoses, such as deep vein thrombosis, compartment syndrome, muscle rupture, soft tissue infection, haemorrhagic or neoplastic processes, myositis, pyomyositis, etc. In the diabetic patient, an unusual diagnosis should be added to this list, i.e. so-called diabetic muscle infarction (DMI). Skeletal muscle infarction is a rare condition occurring specifically in the diabetic patient. Accurate management of DMI depends mainly on the physician's awareness of this condition, which can avoid unnecessary or potentially hazardous investigations and delayed or inadequate treatment. We report a case of DMI in a diabetic woman and a review of 43 previous cases in the literature. Clinical report A 44-year-old woman was hospitalised because of painful swelling of her right thigh. As her thinking was somewhat disturbed, the date of symptom onset remained uncertain. On the day of admission, she complained of continuous severe pain in the anterior right thigh and was unable to walk. The anteromedial distal part of her thigh was enlarged, diffusely firm, tender and warm, with an ill-defined oval mass in the vastus medialis and/or adductor muscles. The knee showed joint effusion but was otherwise normal and free of pain. There was moderate oedema of the left leg without signs of thrombophlebitis. The patient was thin but not febrile and denied any history of trauma or abnormal exercise. She had a history of Type 1 diabetes mellitus diagnosed 5 years earlier, which was poorly controlled because of a lack of compliance with follow-up and treatment. Admission laboratory tests showed fasting blood glucose (19 mmol/l) and moderate acidosis (pH 7.33, bicarbonates 18 mmol/l). The erythrocyte sedimen Continue reading >>

The Effect Of Korean Medical Treatment On Suspected Diabetic Muscle Infarction (dmi)

The Effect Of Korean Medical Treatment On Suspected Diabetic Muscle Infarction (dmi)

The Effect of Korean Medical Treatment on Suspected Diabetic Muscle Infarction (DMI) Park, Lee, Baek, Yang, and Ahn: The Effect of Korean Medical Treatment on Suspected Diabetic Muscle Infarction (DMI) DOI: The Effect of Korean Medical Treatment on Suspected Diabetic Muscle Infarction (DMI) 1Dept. of Acupuncture & Moxibustion Medicine, Samse Korean Medical Hospital 2Dept. of Acupuncture & Moxibustion Medicine, College of Oriental Medicine, Sang-Ji University *Corresponding author: Department of Acupuncture & Moxibustion Medicine, Samse Korean Medical Hospital, 1580 Jungangdaero, Geumjeong-gu, Busan, 46302, Republic of Korea, Tel: +82-51-580-6956, E-mail: [email protected] Received October 04, 2016 Revised November 23, 2016 Accepted November 29, 2016 Copyright 2016 KAMMS. Korean Acupuncture & Moxibustion Medicine Society. All rights reserved. This study reports the clinical effects of Korean medical treatment on a patient with suspected diabetic muscle infarction (DMI). A patient diagnosed with spinal stenosis was suspected of DMI. The patient was treated with acupuncture, bee-venom pharmacopuncture and gastrocnemius stretching. Symptoms were evaluated by verbal numeric rating scale (vNRS), Oswestry disability index (ODI) and Manchester foot pain and disability index (MFPDI). After approximately 5 weeks of Korean medical treatment, including 8 bee-venom treatments, vNRS, ODI, and MFPDI all decreased. Key Words: Diabetic muscle infarction ; Bee Venom ; Korean medicine . On October 2015, Statistics Korea announced healthcare payments status from 2010 to 2014, categorized by the Korean standard classification of disease (KCD). According to the statistics, Korean medical treatments for diseases of the musculoskeletal system and connective tissue steadily increased [ 1 ]. As Continue reading >>

Diabetic Muscle Infarction

Diabetic Muscle Infarction

We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. 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. Diabetes mellitu Continue reading >>

Spontaneous Diabetic Myonecrosis: Report Of Four Cases From A Tertiary Care Institute - Edm Case Reports

Spontaneous Diabetic Myonecrosis: Report Of Four Cases From A Tertiary Care Institute - Edm Case Reports

Spontaneous diabetic myonecrosis: report of four cases from a tertiary care institute Soham Mukherjee 1 , Anuradha Aggarwal 1 , Ashu Rastogi 1 , Anil Bhansali 1 , Mahesh Prakash 2 , Kim Vaiphei 3 and Pinaki Dutta 1 Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India [1] Department of Radiology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India [2] Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India Endocrinology, Diabetes & Metabolism Case Reports, 5 2015, EDM150003, 10.1530/EDM-15-0003 . Spontaneous diabetic muscle infarction (DMI) is a rare and under diagnosed complication of diabetes mellitus. Clinically it presents with acute to subacute onset swelling, pain and tenderness of muscle(s) without systemic manifestations. MRI is helpful in diagnosis, exclusion of other causes and for localization of affected muscle for biopsy in atypical cases. Muscles of the thighs are commonly affected in diabetic myonecrosis (DMN). Here we present the summary of four cases seen in the last 3 years in a tertiary care centre with simultaneous or sequential involvement of multiple groups of muscles or involvement of uncommon sites. All these patients had advanced duration of diabetes with microvascular complications and poor glycemic control. Conservative management including rest and analgesics is the treatment of choice. Short-term prognosis is good but there may be recurrence. A high index of suspicion is required for the diagnosis of DMN which can avoid inadvertent use of antibiotics. Acutesubacute onset severe focal muscle pain in the absence of systemic symptoms in a female patient with long-standing diabetes with microvas Continue reading >>

Treatment And Outcomes Of Diabetic Muscle Infarction

Treatment And Outcomes Of Diabetic Muscle Infarction

Treatment and Outcomes of Diabetic Muscle Infarction Kapur, Suneil MD, FRCPC; McKendry, Robert John MD, FRCPC Background:Diabetic patients can develop spontaneous infarctions of muscle. The optimal treatment of this diabetic muscle infarction (DMI) is unknown. Objective:This analysis was conducted to compare the outcomes of conservative, medical, and surgical treatments of DMI. The primary outcome is the time to recovery. Secondary outcomes include recurrence and mortality rates. Methods:A MEDLINE search from its inception to December 2002 was used to identify reported cases of DMI. We selected those cases that reported on specified baseline characteristics of the patients, including age, gender, duration of diabetes, type of diabetes, diabetic microvascular and macrovascular complications, and the magnetic resonance imaging or computed tomography findings, the type of therapy provided, the time to recovery of initial muscle infarction, recurrences, and deaths. Results:A total of 36 references meeting our inclusion criteria were retrieved, describing 49 patients. Thirty-four patients received conservative therapy (bedrest and analgesics), 8 received medical therapy (antiplatelet agents and/or steroids), and 7 had surgical excision of the infarcted muscle. There were no significant differences in baseline characteristics. The time to recovery from treatment onset was 8.1 weeks, 5.5 weeks, and 13 weeks in the conservative, medical, and surgical treatment groups, respectively. This was statistically significant only when comparing medical and surgical treatment. The respective recurrence rates were 35%, 29%, and 71%. The respective mortality rates within 2 years were 4%, 14%, and 29%. Conclusion:This study supports the use of nonsurgical treatment in patients with DMI. It Continue reading >>

Diabetic Muscle Infarction In A 57 Year Old Male: A Case Report

Diabetic Muscle Infarction In A 57 Year Old Male: A Case Report

Diabetic muscle infarction in a 57 year old male: a case report Litvinov et al.; licensee BioMed Central Ltd.2012 Diabetic muscle infarction is a rare complication of diabetes mellitus (DM) and is often misdiagnosed as cellulitis. This complication is usually associated with poor disease prognosis and high mortality with previous studies reporting a risk of 50% recurrence or another macrovascular complication occurring within one year. Thus, there needs to be greater awareness of this complication of diabetes. In the current work, we present a case report and literature review of DMI occurring in a calf of a 57 year old male. However, unlike the suspected trend, our patient has performed well after this incident and has not sustained another macrovascular event now > 15 month since his original diabetic muscle infarction. Even though diabetic muscle infarction is an uncommon condition, it is important to consider this diagnosis in a diabetic patient. We hope that our findings and literature review will aid clinicians to better diagnose and manage this condition. Diabetic muscle infarctionDiabetic myonecrosis Diabetic muscle infarction (DMI), also known as diabetic myonecrosis, is a rare complication of diabetes mellitus (DM) and is usually associated with poor disease prognosis and high mortality[ 1 , 2 ]. It is often defined as spontaneous ischemic necrosis of skeletal muscle that is unrelated to atheroembolism or occlusion of major arteries[ 2 , 3 ]. The exact prevalence of this condition is not known. A systematic review of the literature from inception to August 2001 identified at total 47 reports describing 166 episodes of DMI[ 2 ]. Usually this condition develops with approximate equal frequency in males and females[ 1 , 2 ]. Established risk factors for acquirin Continue reading >>

Diabetic Muscle Infarction In Thigh

Diabetic Muscle Infarction In Thigh

Your browser does not support the NLM PubReader view. Go to this page to see a list of supporting browsers. J Korean Orthop Assoc. 2012 Feb;47(1):69-74. J Korean Orthop Assoc. 2012 Feb;47(1):69-74. Korean. Published online February 29, 2012. Copyright 2012 by The Korean Orthopaedic Association Yun Sun Choi, M.D.,* and Seung Gyoon Kang, M.D. Department of Orthopedic Surgery, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea. *Department of Radiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea. Correspondence to: Sang Wook Bae, M.D. Department of Orthopedic Surgery, Eulji General Hospital, 280-1, Hagye-dong, Nowon-gu, Seoul 139-711, Korea. TEL: +82-2-970-8260, FAX: +82-2-970-8254, Email: [email protected] Received January 23, 2011; Revised August 12, 2011; Accepted December 13, 2011. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Although ischemia in the distal areas of the limbs due to vascular occlusion is a well recognized systemic condition in patients who have diabetes, infarction of skeletal muscle, not associated with gangrene, is exceedingly rare and the paucity of published cases focused on this condition makes it difficult to determine the most appropriate methods of diagnosis and treatment. The authors encountered a case of diabetic muscle infarction with exquisitely tender swelling on the anteromedial aspect of thigh and herein report the diagnostic work-up and treatment performed on the patient. Keywords: thigh; diabetes mellitus; muscle infarction Clinical Characteristics of Patients with Continue reading >>

Diabetic Myonecrosis

Diabetic Myonecrosis

Diabetic myonecrosis is a complication of diabetes. It is caused by infarcted muscle tissue, usually in the thigh. Epidemiology[edit] The mean age at presentation is thirty-seven years with a reported range of nineteen to sixty-four years. The mean age of onset since diagnosis of diabetes is fifteen years. The female:male ratio is 1.3:1. Other diabetic complications such as nephropathy, neuropathy, retinopathy and hypertension are usually present. Its major symptom is the acute onset muscle pain, usually in the thigh, in the absence of trauma. Signs include exquisite muscle tenderness and swelling. Investigations and diagnosis[edit] Tissue biopsy is the gold standard. Macroscopically this reveals pale muscle tissue. Microscopically infarcted patches of myocytes. Necrotic muscle fibers are swollen and eosinophilic and lack striations and nuclei. Small-vessel walls are thickened and hyalinized, with luminal narrowing or complete occlusion. Biopsy cultures for bacteria, fungi, acid-fast bacilli and stains are negative in simple myonecrosis. Creatine kinase may be normal or increased probably depending upon the stage of the condition when sampling is undertaken. ESR is elevated. Planar X-ray reveals soft tissue swelling and may potentially show gas within necrotic muscle, Bone scan may show non specific uptake later in the course. CT shows muscle oedema with preserved tissue planes (non-contrast enhancing). MRI is the exam of choice and shows increased signal on T2 weighted images within areas of muscle oedema. Contrast enhancement is helpful but must be weighed against the risk of Nephrogenic Systemic Fibrosis as many diabetics have underlying renal insufficiency. Arteriography reveals large and medium vessel arteriosclerosis occasionally with dye within the area of tissue Continue reading >>

Diabetic Muscle Infarction: An Unrecognised Complication Of Diabetes - A Case Report From Subhimalayan Region Of India Mokta Jk, Mokta K, Panda Pk, Bhatia V - Indian J Endocr Metab

Diabetic Muscle Infarction: An Unrecognised Complication Of Diabetes - A Case Report From Subhimalayan Region Of India Mokta Jk, Mokta K, Panda Pk, Bhatia V - Indian J Endocr Metab

Diabetic muscle infarction (DMI) is an unknown complication of poorly controlled long standing diabetes. Presentation, though is well characterised with sudden onset of painful swelling, mostly of the thigh without history of trauma or features of infections. The differential diagnosis is extensive and it is frequently misdiagnosed clinically and treated as polymyositis, pyomyositis and rhabdomyolysis. The uniform clinical presentation and characteristic T2 weighted imaging is sufficient to make the timely diagnosis of DMI and excluding other clinical entities, thus avoiding unnecessary investigations and interventations. [1] An-81- year old diabetic female presented with severe pain and swelling of left thigh in the emergency department in January, 2011. The previous night she woke up suddenly because of the severe pain in her left thigh. The pain was so severe that she couldn't touch her thigh nor could she move it. She denied having any other symptoms. On examination, she was a febrile with pulse rate of 90 beats/min; respiratory rate of 16 breath/min and blood pressure was 160/100 mmHg. Systemic examination of chest, heart and abdomen was also normal. On local examination left thigh was swollen with difference of 12 cm between left and right, indurated and was excruciatingly tender to touch, maximum on anterolateral aspect without any erythema and cellulitis but was warmer than right thigh. Funds examination showed hypertensive along with background diabetic retinopathy changes. Peripheral pulses were symmetrical. There were no muscle fasciculations, muscle atrophy and tenderness of the spine. There was no evidence of neurovascular compromise. Neurological examination revealed absent ankle reflexes and absent vibration sensation at big toe and ankle bilaterally. He Continue reading >>

Diabetic Muscle Infarction: A Systematic Review

Diabetic Muscle Infarction: A Systematic Review

Diabetic muscle infarction: a systematic review We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Diabetic muscle infarction: a systematic review William B Horton, Jeremy S Taylor, [...], and Angela R Subauste Diabetic muscle infarction (DMI) is a rare complication associated with poorly controlled diabetes mellitus. Less than 200 cases have been reported in the literature since it was first described over 45 years ago. There is no clear standard of care for managing these patients. PubMed searches were conducted for diabetic muscle infarction and diabetic myonecrosis from database inception through July 2014. All articles identified by these searches were reviewed in detail if the article text was available in English. The current literature exists as case reports or small case series, with no prospective or higher-order treatment studies available. Thus, an evidence-based approach to data synthesis was difficult. The available literature is presented objectively with an attempt to describe clinically relevant trends and findings in the diagnosis and management of DMI. Early recognition of DMI is key, so appropriate treatment can be initiated. MRI is the radiological study of choice. A combination of bed rest, glycemic control, and non-steroidal anti-inflammatory drug therapy appears to yield the shortest time to symptom resolution and the lowest risk of recurrence. Diabetic muscle infarction (DMI) is a rare and likely under-reco Continue reading >>

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