Diabetic myonecrosis mimicking acute compartment syndrome of
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Diabetic myonecrosis is a very uncommon complication of long-standing diabetes. The presentation is well characterized and management is simple. A 36-year-old lady with a long-standing history of poorly controlled type-1 diabetes was referred by the renal team with acute pain and swelling of the thigh. The patient had clinical findings of compartment syndrome, however the inflammatory markers and CK were marginally elevated which is not common in compartment syndrome. On two previous admissions the patient was subjected to surgical decompression of the thigh for possible acute compartment syndrome secondary to pyomyositis. On both occasions histology showed sterile non-specific muscle necrosis. An MRI scan performed demonstrated skin thickening and diffuse edema within the subcutaneous tissues and the muscles of the thigh. Given the patient’s presentation, previous presentations and subsequent investigations, a diagnosis of diabetic myonecrosis was made and the patient was treated conservatively. The patient recovered uneventfully at 3-weeks.

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