Abstract
We herein report the case of a 42-year-old woman who experienced sudden right upper arm pain, followed by polydipsia and fatigue with the gradual development of disturbed consciousness. Five days later, she visited our emergency room. The detection of a high HbA1c level (15.8 %) and hyperketonemia led to a diagnosis of diabetic ketoacidosis; thus, insulin injection therapy with hydration was initiated. The acute onset of bruising in the patient's right upper arm and cubital region after admission was diagnosed as diabetic muscle infarction (DMI) on magnetic resonance imaging and managed with conservative therapy. DMI, the acute onset of painful swelling of the affected striated muscle, is a rare complication of diabetes thought to be caused by vascular injury and/or abnormalities in the coagulation-fibrinolysis system. Although DMI has a favorable therapeutic outcome, the prognosis may be poor if the patient has severe diabetic vascular complications. Therefore, physicians should consider the possibility of DMI in diabetic patients presenting with limb pain and/or swelling.
