Bilateral Thigh Myonecrosis in Diabetes: A Case Report

Diabetic myonecrosis is an uncommon complication of poorly controlled diabetes mellitus. Usually, patients present with acute painful swelling of the affected muscles, mostly the quadriceps muscle of the thigh. We present the case of a 57-year-old male with type 2 diabetes mellitus who presented with progressive bilateral thigh pain and reduced movement. Blood results indicated slightly elevated creatine kinase, C-reactive protein, and erythrocyte sedimentation rate levels, and poor diabetes control. Magnetic resonance imaging showed features suggestive of myonecrosis. A muscle biopsy demonstrated active myofiber necrosis consistent with diabetic myonecrosis. The patient's symptoms improved after 11 days of treatment with intravenous fluids, painkillers, glycemic control, and physical therapy. This will highlight the importance of suspecting diabetic myonecrosis in patients presenting with bilateral acute swollen leg pain with a background of uncontrolled diabetes mellitus.