39 male
Sudden onset thigh pain week following hospital admission with septic subacromial/subcoracoid bursitis ( now treated)
However at this visit white cell count , CRP not markedly elevated .
Although not volunteered on requisition form , further enquiry established patient has very poorly controlled/managed Type 2 diabetes mellitus
Diagnosis and discussion follows
DIAGNOSIS : DIABETIC MYONECROSIS
Sudden onset thigh pain week following hospital admission with septic subacromial/subcoracoid bursitis ( now treated)
However at this visit white cell count , CRP not markedly elevated .
Although not volunteered on requisition form , further enquiry established patient has very poorly controlled/managed Type 2 diabetes mellitus
Diagnosis and discussion follows
 |
| POST GADOLINIUM |
 |
| POST GADOLINIUM |
DIAGNOSIS : DIABETIC MYONECROSIS
Occurs in poorly controlled diabetes
Commonly thigh muscles
Sudden onset pain .Lab markers ( CRP, WBC ) typically only mildly deranged
Usually self limiting
Another teaching point is that in my experience, diabetes is often not volunteered on requisition forms for MSK studies but may be very relevant
Apologies for duplicating post - I ended up testing both email and blogger
ReplyDeleteBlogger works better for me ( eg more control over order and labelling images) and is a fairly straightforward interface although I will need to experiment a bit with "teaser" option I think ...
Great case Andrew!
ReplyDelete