AI Article Synopsis
- A 49-year-old woman with type 2 diabetes and past spinal cord injury presented with leg swelling and weakness, leading to the discovery of diabetic myonecrosis, a rare condition.
- Recent reviews indicate that diabetic myonecrosis is mainly associated with poorly controlled diabetes, contrary to this patient's well-managed blood sugar levels.
- The case highlights the importance of considering diabetic myonecrosis in diabetic patients experiencing unexplained pain and swelling, even when lab results appear normal.
Article Abstract
Introduction: A patient with well-controlled type 2 diabetes was found to have diabetic myonecrosis, a rare condition associated with poorly controlled type 2 diabetes. Diagnosis was masked by concern for lumbosacral plexopathy from a history of spinal cord infarct.
Case Presentation: A 49-year-old African American woman with type 2 diabetes and paraplegia secondary to spinal cord infarct presented to the emergency department with left leg swelling and weakness from her hip to toes. Hemoglobin A1c was 6.0%, and there was no leukocytosis or elevated inflammatory markers. Computed tomography showed evidence of infectious process or possible diabetic myonecrosis.
Discussion: Recent reviews show fewer than 200 reports of diabetic myonecrosis since first described in 1965. It typically is seen in poorly controlled types 1 and 2 diabetes, with average hemoglobin A1c of 9.34% at time of diagnosis.
Conclusions: Diabetic myonecrosis should be considered in diabetic patients with unexplained swelling and pain - particularly in the thigh - even with unremarkable lab values.
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