Retrospective Analysis of Treatment Modalities in Diabetic Muscle Infarction

Overview

Journal Open Access Rheumatol

Publisher Dove Medical Press

Specialty Rheumatology

Date 2014 Jan 10

PMID 27790029

Citations 3

Authors

Ikenna Onyenemezu

Eugenio Capitle Jr

Affiliations

Soon will be listed here.

Abstract

Background: Diabetic muscle infarction (DMI) is a spontaneous necrosis of skeletal muscle of unknown etiology. The major risk factor is longstanding uncontrolled diabetes mellitus (DM). Optimal treatment for DMI is not known. The purpose of this study was to analyze the outcome of surgical treatment, physiotherapy, and bed rest in DMI.

Methods: We searched Medline from its inception to April 2013. We selected cases that provided sufficient data on recovery duration, recurrences, and non-recurrences. Baseline characteristics, including age, sex, microvascular complications, lesion size estimated on magnetic resonance imaging, type of diabetes, and duration of diabetes were assessed. The primary outcome was mean time to recovery from initial treatment and secondary outcomes were mean time to recurrence and recurrence rate.

Results: Mean time to recovery was 149 (95% confidence interval [CI] 113-186), 71 (95% CI 47-96), and 43 (95% CI 30-57) days for surgery, physiotherapy and bed rest, respectively. These figures were statistically significant only for surgery versus physiotherapy and surgery versus bed rest (<0.01). Mean time to recurrence was 30, 107, and 297 days for surgery, physiotherapy, and bed rest, respectively. The recurrence rate was 57%, 44%, and 24% for surgery, physiotherapy, and bed rest, respectively.

Conclusion: Our results show a similar outcome for physiotherapy as compared with bed rest. It also confirms nonsurgical treatment as a better therapeutic option compared with surgical treatment.

Citing Articles

Diabetic Muscle Infarction-A Rare Diabetic Complication: Literature Review and Case Report.

Rabczynski M, Fenc M, Kuznik E, Lubieniecki P, Halon A Int J Environ Res Public Health. 2023; 20(4).

PMID: 36834084 PMC: 9966745. DOI: 10.3390/ijerph20043390.

Diabetic muscle infarction: often misdiagnosed and mismanaged.

Verjee M, Abdelsamad N, Qureshi S, Malik R Diabetes Metab Syndr Obes. 2019; 12:285-290.

PMID: 30881071 PMC: 6408199. DOI: 10.2147/DMSO.S185839.

Diabetic muscle infarction: a systematic review.

Horton W, Taylor J, Ragland T, Subauste A BMJ Open Diabetes Res Care. 2015; 3(1):e000082.

PMID: 25932331 PMC: 4410119. DOI: 10.1136/bmjdrc-2015-000082.

References

Brower R . Consequences of bed rest. Crit Care Med. 2010; 37(10 Suppl):S422-8. DOI: 10.1097/CCM.0b013e3181b6e30a. View

Bjornskov E, Carry M, KATZ F, Lefkowitz J, Ringel S . Diabetic muscle infarction: a new perspective on pathogenesis and management. Neuromuscul Disord. 1995; 5(1):39-45. DOI: 10.1016/0960-8966(94)e0027-6. View

Schattner A, Zornitzki T, Adi M, Friedman J . Painful swelling in the thigh: diabetic muscle infarction. CMAJ. 2009; 180(1):72-4. PMC: 2612048. DOI: 10.1503/cmaj.080572. View

Ali A, Conti M, Massucco P, Trovati M . Diabetic muscle infarction associated with multiple autoimmune disorders, IgA deficiency and a catastrophically poor glycaemic control: a case report. Diabetes Nutr Metab. 2003; 16(2):134-7. View

BANKER B, Chester C . Infarction of thigh muscle in the diabetic patient. Neurology. 1973; 23(7):667-77. DOI: 10.1212/wnl.23.7.667. View

Lauro G, Kissel J, Simon S . Idiopathic muscular infarction in a diabetic patient. Report of a case. J Bone Joint Surg Am. 1991; 73(2):301-4. View

Van Slyke M, Ostrov B . MRI evaluation of diabetic muscle infarction. Magn Reson Imaging. 1995; 13(2):325-9. DOI: 10.1016/0730-725x(94)00102-9. View

Kapur S, McKendry R . Treatment and outcomes of diabetic muscle infarction. J Clin Rheumatol. 2005; 11(1):8-12. DOI: 10.1097/01.rhu.0000152142.33358.f1. View

Silberstein L, Britton K, Marsh F, Raftery M, DCruz D . An unexpected cause of muscle pain in diabetes. Ann Rheum Dis. 2001; 60(4):310-2. PMC: 1753615. DOI: 10.1136/ard.60.4.310. View

10.

Yoo W, Kim C, Park J, Kim H, Kim J, Park T . Case report: diabetic muscle infarction presenting as knee arthralgia. Rheumatol Int. 2001; 21(1):36-9. DOI: 10.1007/s002960100124. View

11.

Joshi R, Vargas R . Diabetic muscle infarction in renal transplantation. Transplantation. 2004; 77(2):321. DOI: 10.1097/01.TP.0000100482.26336.52. View

12.

Parmar M . Diabetic muscle infarction. BMJ. 2009; 338:b2271. DOI: 10.1136/bmj.b2271. View

13.

Habib G, Nashashibi M, Saliba W, Haj S . Diabetic muscular infarction: emphasis on pathogenesis. Clin Rheumatol. 2003; 22(6):450-1. DOI: 10.1007/s10067-003-0789-z. View

14.

Khoury N, El-Khoury G, Kathol M . MRI diagnosis of diabetic muscle infarction: report of two cases. Skeletal Radiol. 1997; 26(2):122-7. DOI: 10.1007/s002560050205. View

15.

Huang B, Monu J, Doumanian J . Diabetic myopathy: MRI patterns and current trends. AJR Am J Roentgenol. 2010; 195(1):198-204. DOI: 10.2214/AJR.09.2494. View

16.

Barton K, Palmer B . Bilateral infarction of the vastus lateralis muscle in a diabetic patient: a case report and review of the literature. J Diabetes Complications. 1993; 7(4):221-3. View

17.

Litvinov I, Radu A, Garfield N . Diabetic muscle infarction in a 57 year old male: a case report. BMC Res Notes. 2012; 5:701. PMC: 3577448. DOI: 10.1186/1756-0500-5-701. View

18.

Chow K, Szeto C, Wong T, Cheuk A, Kam-Tao Li P . Diabetic muscle infarction: myocardial infarct equivalent. Diabetes Care. 2002; 25(10):1895. DOI: 10.2337/diacare.25.10.1895. View

19.

Gardner C, Motta A, Ashmead J . Skeletal muscle infarction in diabetes: MR findings. J Comput Assist Tomogr. 1993; 17(6):986-8. DOI: 10.1097/00004728-199311000-00027. View

20.

Kapur S, Brunet J, McKendry R . Diabetic muscle infarction: case report and review. J Rheumatol. 2004; 31(1):190-4. View