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Muscle infarction: do you think about it in a diabetic patient?

Diabetic muscle infarction (DMI) is an uncommon complication of long standing diabetes (DM). This abnormal condition may occur in poorly controlled patients with type 1 and 2 DM with established microangiopathy. Clinical presentation is usually acute with severely painful swelling of the affected muscle, which persists for many weeks and has spontaneous recovery. Albeit uncertain, its etiology is associated with microangiopathy with occlusion of small arteries. This condition is diagnosed by biopsy although results from T2 - weight magnetic resonance are typical. Pain management, bed rest and careful metabolic control are the treatment of choice. We report 3 cases of DMI admitted to a general hospital who were initially misdiagnosed and led to inadequate treatment and management at onset of the condition. We emphasize the clinical, image and histological aspects of DMI in order to allow early awareness of this uncommon condition, avoiding unnecessary delay as well as hastening appropriate treatment.

Muscle infarction; Diabetes mellitus; Complication; Microangiopathy; Swelling muscle; Pain


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