Diabetic Myonecrosis: A Case Report of Acute Muscle Infarction in a Patient with Long-Standing Diabetes Mellitus Diabetic Myonecrosis in Long-Standing Diabetes

Abstract

Background: Diabetic myonecrosis is a rare complication of long-standing, poorly controlled diabetes mellitus, often associated with microvascular complications and diagnostic challenges. Early recognition and appropriate management are crucial to avoid unnecessary interventions and optimize patient outcomes.
Objective: To report a case of diabetic myonecrosis in a patient with poorly controlled diabetes and highlight its diagnostic approach and management.
Methods: A 49-year-old male with a 30-year history of uncontrolled type 1 diabetes presented with acute pain and swelling in the right thigh. Laboratory investigations included complete blood count, ESR, CRP, and HbA1c. Imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) were used to evaluate muscle involvement. Conservative management included optimized insulin therapy, aspirin, and analgesics.
Results: Laboratory findings showed elevated ESR (121 mm/hr), CRP (3.98 mg/dL), and HbA1c (15.2%). MRI confirmed diffuse muscle edema in the right adductor muscles. Following treatment, pain severity decreased from 8/10 to 2/10, and mobility significantly improved over a two-week period.
Conclusion: Early diagnosis and conservative management of diabetic myonecrosis can prevent complications. Clinicians should consider this condition in patients with acute musculoskeletal pain and poorly controlled diabetes.