Diabetic Myonecrosis as a Rare Cause of Acute Onset Severe Leg Pain in a Patient on Hemodialysis - Case Report and Review of Literature

Abstract

Diabetic muscle infarction (DMI) or diabetic myonecrosis (DMN) is a rarely reported and commonly underdiagnosed microvascular complication of longstanding uncontrolled diabetes mellitus. The authors report a case of elderly male with type 2 diabetes mellitus, in his mid-fifties who presented with complaints of acute onset, sharp and persistent pain in lateral aspect of the left thigh associated with marked tenderness. The routine laboratory investigation is often nonspecific and do not provide much value in diagnosis of DMI. Magnetic resonance imaging in combination with a proper history can help in diagnosis. Muscle biopsy can help in diagnosis but is usually not recommended as it prolongs the disease process and delays recovery. Treatment is rest, analgesics, and maintenance of optimal glycaemic control.