Diabetic Myonecrosis: A Diagnostic and Treatment Challenge in Longstanding Diabetes

Case Reports in Endocrinology
28 Jan, 2019 ,

A 41-year-old-female presented with right leg pain since 2-weeks. She was a k/c/o DM and ESRD, CCF and was on hemodialysis. She also had a h/o recently resolved  left lower extremity cellulitis. She did not give any h/o trauma. Venous doppler showed normal blood flow. CT angiogram of the abdomen and pelvis showed soft tissue and fascial edema of the right thigh. Patient received analgesics and was discharged after glycemic control. She was readmitted 7-days-later post fall, with swollen right thigh and limited activity in right knee and hip without any evidence of effusion. Inflammatory markers were very high and MRI suggested ischemic changes in the right thigh musculature. A diagnosis of Diabetic Myonecrosis was made and the patient was treated accordingly.