Diabetic Muscle Infarction in Thigh

Ho Yoon Kwak; Sang Wook Bae; Yun Sun Choi; Seung Gyoon Kang

doi:10.4055/jkoa.2012.47.1.69

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Kwak, Bae, Choi, and Kang: Diabetic Muscle Infarction in Thigh

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2012; 47(1): 69-74.

Published online: 29 February 2012

DOI: https://doi.org/10.4055/jkoa.2012.47.1.69

Diabetic Muscle Infarction in Thigh

Ho Yoon Kwak, M.D., Sang Wook Bae, M.D., Yun Sun Choi, M.D.^*, Seung Gyoon Kang, M.D.

Department of Orthopedic Surgery, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.

^*Department of Radiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.

Correspondence to: Sang Wook Bae, M.D. Department of Orthopedic Surgery, Eulji General Hospital, 280-1, Hagye-dong, Nowon-gu, Seoul 139-711, Korea. TEL: +82-2-970-8260, FAX: +82-2-970-8254, bsw2402@eulji.ac.kr

Received 23 January 2011 Revised 12 August 2011 Accepted 13 December 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although ischemia in the distal areas of the limbs due to vascular occlusion is a well recognized systemic condition in patients who have diabetes, infarction of skeletal muscle, not associated with gangrene, is exceedingly rare and the paucity of published cases focused on this condition makes it difficult to determine the most appropriate methods of diagnosis and treatment. The authors encountered a case of diabetic muscle infarction with exquisitely tender swelling on the anteromedial aspect of thigh and herein report the diagnostic work-up and treatment performed on the patient.

Keywords: thigh, diabetes mellitus, muscle infarction

Figures and Tables

Figure 1

Plain radiograph shows soft tissue swelling on left thigh.

Figure 2

Doppler ultrasonography shows normal vessel lumen and normal flow of the common femoral vessel.

Figure 3

Axial post-contrast computed tomography scan of the left thigh shows enlargement and low attenuation in the adductor and vastus medialis muscles with peripheral irregular enhancement (white arrows) and central enhancing foci. Note well fixed ring enhancement (black arrows) surrounding vastus intermedius muscle. There are many strands in the subcutaneous fat indicative of edema.

Figure 4

Axial fat-suppression T2-weighted fast spin echo (A) and coronal short tau inversion recovery (B) magnetic resonance (MR) images show enlargement and high signal intensity in the left thigh muscles, including adductors (asterisks), vastus medialis, sartorius and gluteus maximus. More superficially there is subfascial fluid. Diffuse subcutaneous edema at both sides is also noted. On coronal T1-weighted spin echo MR image (C), the affected muscles are slightly hypointense.

Table 1

Clinical Characteristics of Patients with Diabetic Muscular Infarction

DM, diabetes mellitus; M, male; F, female; E, diabetic retinopathy; K, diabetic nephropathy; N, peripheral neuropathy; NR, not reported; Rt, right; Lt, left; Cons. Tx, conservative treatment.

References

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