Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 1;73(3):500-505.
doi: 10.4103/neurol-india.Neurol-India-D-23-00672. Epub 2025 May 23.

Insights into Diabetes Muscle Infarction: Clinical Characteristics and Outcome

Vaibhav Singhal  1 , Jeyakumar Meyyappan  2 , Neeraj Jain  3 , Dharmendra Bhadauria  2 , Preeti Dabadghao  1 , Sushil Kumar Gupta  1 , Subhash Chandra Yadav  1
Affiliations
Free article

Insights into Diabetes Muscle Infarction: Clinical Characteristics and Outcome

Vaibhav Singhal et al. Neurol India. .
Free article

Abstract

Background: Diabetes muscle infarction (DMI) is a common misdiagnosed and under-reported diabetes complication. This causes a delay in diagnosis, which increases the morbidity of the disease.

Objective: To review all cases of DMI and its pathogenesis, clinical features, prognostic implications, and management.

Methods: We retrospectively analyzed 12 DMI patients diagnosed in the past 15 years. We investigated the disease's clinical characteristics, laboratory results, imaging features, therapies, and prognostic progression.

Result: DMI patients were diagnosed at a mean age of 50 years (range: 33-78 years), were predominantly males (n = 7), and 11 (92%) had type 2 diabetes. They had diabetes for a long time (mean duration 12.6 years). Almost all the patients had nephropathy, neuropathy, or retinopathy. Before presentation, these patients had been symptomatic for an average of 50 days (range: 10-120 days). Most patients presented with unilateral lower limb swelling, local pain and tenderness, and a raised temperature, as well as severe motion-dependent pain. The quadriceps muscle was the most affected, with only one patient experiencing upper limb involvement. On T2W, MRI revealed heterogeneously enlarged muscles with post-contrast enhancement; post-contrast scans revealed multiple focal hypo-enhancing areas, indicating myonecrosis. All the patients were managed conservatively with a good short-term prognosis.

Conclusion: When a patient presents with a painful, tender lump in the lower limb without a history of trauma, DMI should be strongly suspected. MRI findings are diagnostic, and no biopsy is required. Due to multiple comorbidities, these patients are typically managed conservatively, with a good short-term but poor long-term prognosis.

Keywords: Cellulitis; diabetes mellitus; magnetic imaging resonance; muscle infarction; myonecrosis; myositis.

PubMed Disclaimer

References

    1. Trujillo-Santos AJ. Diabetic muscle infarction: An underdiagnosed complication of long-standing diabetes. Diabetes Care 2003;26:211–5.
    1. Horton WB, Taylor JS, Ragland TJ, Subauste AR. Diabetic muscle infarction: A systematic review. BMJ Open Diabetes Res Care 2015;3:e000082.
    1. Ganokroj P, Boonchaya-Anant P. Diabetic muscle infarction: Rare complication with a distinct clinical manifestation. BMJ Case Rep 2019;12:10–3.
    1. Jariwal R, Raza N, Cadang C, Rahman S, Contreras D, Sidhu R, et al. Diabetic muscle infarction: Resolution of rare microangiopathy with over-the-counter medication. Case Rep Med 2021;2021:5555051.
    1. Bunch TJ, Birskovich LM, Eiken PW. Diabetic myonecrosis in a previously healthy woman and review of a 25-year Mayo clinic experience. Endocr Pract 2002;8:343–6.