Ramachandran Vignesh
Department of Dermatology, New York University, New York, New York.
Department of Internal Medicine, Texas Health Presbyterian Hospital, Dallas, Texas.
Proc (Bayl Univ Med Cent). 2022 Jun 10;35(5):693-694. doi: 10.1080/08998280.2022.2086787. eCollection 2022.
A 37-year-old woman with uncontrolled type 1 diabetes mellitus and end-stage renal disease presented to our hospital with 10 days of severe left thigh pain. Physical examination revealed warmth, swelling, and tenderness of the left anterior and medial thigh. Workup revealed a mildly elevated creatinine kinase. Magnetic resonance imaging without contrast revealed diffuse extensive soft tissue edema and a heterogeneous, tubular fluid collection within the adductor magnus. Needle aspiration revealed hematoma and myonecrosis. Cultures and cytology were negative. A diagnosis of diabetic myonecrosis was made. Myonecrosis is a rare complication of diabetes, and the gold standard for diagnosis is tissue biopsy. However, magnetic resonance imaging may be sensitive and specific for diagnosis and prevent morbidity.
一名37岁的1型糖尿病控制不佳且处于终末期肾病的女性因左大腿剧痛10天前来我院就诊。体格检查发现左大腿前内侧温暖、肿胀且有压痛。检查发现肌酸激酶轻度升高。无对比剂的磁共振成像显示弥漫性广泛软组织水肿以及内收大肌内不均匀的管状液体积聚。针吸活检显示有血肿和肌坏死。培养及细胞学检查均为阴性。诊断为糖尿病性肌坏死。肌坏死是糖尿病的一种罕见并发症，诊断的金标准是组织活检。然而，磁共振成像对于诊断可能具有敏感性和特异性，且可预防发病。
