22: Diabetic Myonecrosis - Mahoney Flashcards
A1c to blood glucose conversion
A1C x 33.3 - 86 = blood glucose level
What does humulin N 70/30 mean?
percent of every unit (intermediate/regular insulin)
what medication might cause muscle pain?
statins
what type of neuropathy attacks the thighs more?
diabetic amyotrophy
proximal diabetic neuropathy
what eosinophil level might indicate a parasite infection?
greater than 6%
what does a sed rate tell you?
marker of generalized inflammation in the body
Males: age/2 = normal sed rate
what would a CPK tell you?
creatinine kinase
tells if muscle tissue injury present
fluid looks ______ on T1 and _____ on T2
black
white/bright
MRI findings: ________ to muscle on T1; _________ on T2
hypointense
hyperintense
____ IV gadolinium on a T1 will show _________ for an abscess
dark central area surrounded by a bright brim
need to use IV gadolinium to check for abscess
where is diabetic myonecrosis most likely to appear?
pain and swelling in anterior thigh (80%) or calf (20%)
what lab markers are there for diabetic myonecrosis?
no specific laboratory marker
leukocytosis less than 10% of cases
elevated CK in 50% of cases
pathogenesis of diabetic myonecrosis (2)
- vascular disease (ischemia –> soft tissue swelling –> increased pressure –> decreased blood flow)
- hypercoagulability (increased factor VII activity, increased levels of tissue plasminogen activator inhibitor and thrombomodulin, impaired response of tissue plasminogen activator to venous occlusion, cases of antiphopholipid syndrome found as etiology)
most valuable diagnostic technique
MRI
treatment
self-limiting disease
supportive rest and analgesia
