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Rare disease
Case report
Diabetic amyotrophy, not your typical back pain
  1. Jonathan Seung Doe Na1 and
  2. Philip C Dittmar2
  1. 1Medicine, University of Maryland Medical System, Baltimore, Maryland, USA
  2. 2Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA
  1. Correspondence to Dr Philip C Dittmar; pdittmar{at}som.umaryland.edu

Abstract

A 49-year-old man presented to the hospital for spinal cord decompression surgery with left buttock and left leg pain. The patient described an acute burning pain radiating down from his left buttock to left lateral leg. He also noted a 13.6 kg weight loss in recent months. Physical examination showed decreased muscle bulk of the left thigh, decreased strength of the left hip, left knee flexors and extensors. Recent MRI spine showed mild canal narrowing and cord flattening in the lower thoracic spine. Serologic testing showed an elevated glucose of 17.9 mmol/L and haemoglobin A1c of 9.8%. Electromyography showed denervation of scattered muscles of the left knee flexors, hip flexors and adductors. In the setting of newly diagnosed diabetes mellitus, he was diagnosed with diabetic amyotrophy, started on insulin therapy, and his surgery was cancelled.

  • diabetes
  • orthopaedic and trauma surgery
  • neuromuscular disease
  • peripheral nerve disease

https://doi.org/10.1136/bcr-2019-231928

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    Footnotes

    • Twitter @PDittyMD

    • Contributors JSDN and PCD contributed substantially to the conception and design of the work, drafted and revised the manuscript, have final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.