Diabetic myonecrosis
Diabetic myonecrosis is a complication of
Epidemiology
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
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
Tissue
acid-fast bacilli
and stains are negative in simple myonecrosis.
Arteriography reveals large and medium vessel arteriosclerosis occasionally with dye within the area of tissue infarction. Electromyography
shows non specific focal changes.
Treatment
Treatment includes supportive care with
analgesics and anti-inflammatory
agents. Exercise should be limited as it increases pain and extends the area of infarction. Symptoms usually resolve in weeks to months, but fifty percent of sufferers will experience relapse in either leg.
Pathophysiology
The pathogenesis of this disease is unclear.
fibrinolytic pathways such as antiphospholipid syndrome.[2]
Differential Diagnosis
A large number of conditions may cause symptoms and signs similar to diabetic myonecrosis and include:
lymphoedema, sarcoidosis, tuberculosis, cat-scratch disease, amyloidosis, as well as tumours of lipoma, chondroma, fibroma, leiomyoma, and sarcoma
.
References
- Wintz R, Pimstone K, Nelson S (Sep–Oct 2006). "Detection of diabetic myonecrosis. Complication is often-missed sign of underlying disease". Postgrad Med. 119 (3): 66–9. S2CID 37757547. – Case report
- Mousa A, Hussein S, Daggett P, Coates P (7–9 November 2005). "Spontaneous non-traumatic muscle pain in diabetes" (abstract page). Endocrine Abstracts. 10: DP12. – Poster Presentation, 196th Meeting of the Society for Endocrinology, London, UK
- Subbiah V, Raina R, Kaelber D, Chung-Park M, Halle D, Mansour D, Perzy H (2004). "Diabetic Myonecrosis (Rare And Ominous Complication Of A Common Disease)" (PDF). American Medical Association Research Symposium. Archived from the original (PDF) on 2006-09-26. Retrieved 2006-08-24. – Poster presentation