Garten Brandon, Schwade Mark, Alkathiri Saleh, Perry Lane
Medical College of Georgia, Augusta University, USA.
J Investig Med High Impact Case Rep. 2025 Jan-Dec;13:23247096251331890. doi: 10.1177/23247096251331890. Epub 2025 Mar 31.
Diabetic myonecrosis is a rare complication of poorly controlled diabetes that presents as spontaneous limb pain and swelling. It is associated with other microvascular diabetic complications such as nephropathy or retinopathy and is frequently misdiagnosed given its resemblance to infectious and vascular complications. We present a case of a 49-year-old male with poorly controlled type 2 diabetes and a history of recurrent thigh pain. This was initially treated as cellulitis, but the patient experienced persistent severe pain despite multiple rounds of antibiotics. Imaging with MRI ultimately confirmed a diagnosis of diabetic myonecrosis. The patient was successfully managed with a combination of aspirin, insulin therapy, and a multimodal pain regimen, leading to significant clinical improvement. This condition poses a diagnostic challenge due to its rarity and nonspecific presentation, often leading to delays in appropriate treatment. Prompt diagnosis with exclusionary testing and imaging, followed by appropriate management, can prevent severe complications. Additional research is needed to establish a standardized protocol for treating this condition.
糖尿病性肌坏死是糖尿病控制不佳的一种罕见并发症，表现为自发性肢体疼痛和肿胀。它与其他糖尿病微血管并发症如肾病或视网膜病变相关，并且由于其与感染性和血管性并发症相似，常被误诊。我们报告一例49岁男性，患有控制不佳的2型糖尿病并有复发性大腿疼痛病史。最初该患者被当作蜂窝织炎治疗，但尽管使用了多轮抗生素，患者仍持续遭受剧痛。最终通过磁共振成像（MRI）检查确诊为糖尿病性肌坏死。该患者通过联合使用阿司匹林、胰岛素治疗和多模式镇痛方案成功得到治疗，临床症状显著改善。由于这种疾病罕见且表现不具特异性，因此在诊断上具有挑战性，常常导致适当治疗的延误。通过排除性检查和影像学进行快速诊断，随后进行适当治疗，可预防严重并发症。需要进一步研究以建立治疗这种疾病的标准化方案。
