Spontaneous muscle infarction in diabetic patients is a rare condition that usually occurs in those with advanced diabetic complications. Increased clinical awareness is important for early recognition, particularly in a diabetic patient presenting with a painful thigh or leg swelling. However, the disorder has received little attention in the rehabilitation medicine literature. Magnetic resonance imaging is the diagnostic choice of study, and in the appropriate clinical setting, may obviate the need for a muscle biopsy. We reported three patients with diabetic muscle infarction, review additional reported cases, and discussed the principles of diagnosis and management.

Diabetic muscle infarction is a rare complication of diabetes and is characterized by acute or subacute onset of painful and non-pitting swelling of the thigh or the calf, and rarely in the upper limbs. Diabetic muscle infarction and cerebral vascular accidents ocurr in patients with advanced diabetic complications. Painful swelling of the extremities is very common manifestation in patients with hemiplegia. Thus, early correct diagnosis and differential diagnosis of the underlying causes of painful swelling of the extremities are very important in these patients. We report a case of diabetic muscle infarction in a patient with hemiplegia, and suggest that diabetic muscle infarction should be considered as a disease of differential diagnosis for acute pain and swelling on the extremity.