Diabetic myonecrosis
Updates to Article Attributes
Diabetic myonecrosis is an uncommon complication of diabetes mellitus, occurring in patients with chronic poor controlglycemic control.
Epidemiology
There is a slight predilection for females and typepatients with type 1 diabeticsdiabetes.
Clinical presentation
PatientPatients present with with pain, tenderness, and swelling, more often in the lower limbs, with the thigh being the most common site.
Pathology
The exact cause is unknown but diabetic myonecrosis is a skeletal muscle injury from atherosclerotic occlusion, hypoxia-reperfusion or vasculitis with thrombus.
Radiographic features
CT
- diffuse muscle enlargement with decreased attenuation
-
hyperdensehyperattenuating subcutaneous fat 2
MRI
MRI findings are non-specific, but a mass-like area of muscle necrosis is noted 1,2,5,6:
- T1: iso to hypointense
- T2 FS: enlarged muscle(s) with diffuse high signal
-
Gad C+: heterogeneous/peripheral
enhancmentenhancement
Differential diagnosis
- infection, e.g. pyomyositis, necrotising fasciitis, abscess, cellulitis
- acute compartment syndrome
Treatment and prognosis
Normally responds well to conversative treatment and is self-limiting. High (>50%) recurrence rates are reported 2,3. Prognosis is poor with most patients dying within five years 4.
History and etymology
Diabetic myonecrosis was first described by Angervall and Stener in 1965.
See also
-<p><strong>Diabetic myonecrosis</strong> is an uncommon complication of diabetes mellitus, occurring in patients with chronic poor control. </p><h4>Epidemiology</h4><p>There is a slight predilection for females and type 1 diabetics. </p><h4>Clinical presentation</h4><p>Patient present with pain, tenderness and swelling, more often in the lower limbs, with the thigh being the most common site. </p><h4>Pathology</h4><p>The exact cause is unknown but diabetic myonecrosis is a skeletal muscle injury from atherosclerotic occlusion, hypoxia-reperfusion or vasculitis with thrombus. </p><h4>Radiographic features</h4><h5>CT</h5><ul>- +<p><strong>Diabetic myonecrosis</strong> is an uncommon complication of diabetes mellitus, occurring in patients with chronic poor glycemic control. </p><h4>Epidemiology</h4><p>There is a slight predilection for females and patients with type 1 diabetes. </p><h4>Clinical presentation</h4><p>Patients present with pain, tenderness, and swelling, more often in the lower limbs, with the thigh being the most common site. </p><h4>Pathology</h4><p>The exact cause is unknown but diabetic myonecrosis is a skeletal muscle injury from atherosclerotic occlusion, hypoxia-reperfusion or vasculitis with thrombus. </p><h4>Radiographic features</h4><h5>CT</h5><ul>
-<li>hyperdense subcutaneous fat <sup>2</sup>- +<li>hyperattenuating subcutaneous fat <sup>2</sup>
-</ul><h5>MRI</h5><p>MRI findings are non-specific but a mass-like area of muscle necrosis is noted <sup>1,2,5,6</sup>:</p><ul>- +</ul><h5>MRI</h5><p>MRI findings are non-specific, but a mass-like area of muscle necrosis is noted <sup>1,2,5,6</sup>:</p><ul>
-<strong>Gad C+</strong>: heterogeneous/peripheral enhancment</li>- +<strong>Gad C+</strong>: heterogeneous/peripheral enhancement</li>
-<li>infection, e.g. pyomyositis, <a title="Necrotising fasciitis" href="/articles/necrotising-fasciitis">necrotising fasciitis</a>, abscess, cellulitis</li>-<li><a title="acute compartment syndrome" href="/articles/acute-compartment-syndrome">acute compartment syndrome</a></li>- +<li>infection, e.g. pyomyositis, <a href="/articles/necrotising-fasciitis">necrotising fasciitis</a>, abscess, cellulitis</li>
- +<li><a href="/articles/acute-compartment-syndrome">acute compartment syndrome</a></li>
-<li><a title="myonecrosis" href="/articles/myonecrosis">myonecrosis</a></li>-<li><a title="Calcific myonecrosis" href="/articles/calcific-myonecrosis">calcific myonecrosis</a></li>- +<li><a href="/articles/myonecrosis">myonecrosis</a></li>
- +<li><a href="/articles/calcific-myonecrosis">calcific myonecrosis</a></li>
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