Diabetic amyotrophy, not your typical back pain
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 show...
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| description | 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. |
| doi_str_mv | 10.1136/bcr-2019-231928 |
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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.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2019-231928</identifier><identifier>PMID: 31924707</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Atrophy ; Back pain ; Back Pain - etiology ; Case reports ; Diabetes ; Diabetic Neuropathies - complications ; Diabetic Neuropathies - drug therapy ; Diagnosis, Differential ; Electromyography ; Family medical history ; Glucose ; Hemoglobin ; Hepatitis ; Hospitals ; Humans ; Hypoglycemic Agents - therapeutic use ; Insulin Glargine - therapeutic use ; Leg - physiopathology ; Male ; Medical research ; Metabolism ; Middle Aged ; Multiple myeloma ; neuromuscular disease ; orthopaedic and trauma surgery ; Patients ; peripheral nerve disease ; Rare Disease ; Spinal cord ; Surgeons ; Surgery</subject><ispartof>BMJ case reports, 2020-01, Vol.13 (1), p.e231928</ispartof><rights>BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b492t-6ebd2091d8816e3c30cfe3e30b8025db7a3c3fd357f971293175e86b1e1bd3893</citedby><cites>FETCH-LOGICAL-b492t-6ebd2091d8816e3c30cfe3e30b8025db7a3c3fd357f971293175e86b1e1bd3893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954816/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954816/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31924707$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Na, Jonathan Seung Doe</creatorcontrib><creatorcontrib>Dittmar, Philip C</creatorcontrib><title>Diabetic amyotrophy, not your typical back pain</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><addtitle>BMJ Case Rep</addtitle><description>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.</description><subject>Atrophy</subject><subject>Back pain</subject><subject>Back Pain - etiology</subject><subject>Case reports</subject><subject>Diabetes</subject><subject>Diabetic Neuropathies - complications</subject><subject>Diabetic Neuropathies - drug therapy</subject><subject>Diagnosis, Differential</subject><subject>Electromyography</subject><subject>Family medical history</subject><subject>Glucose</subject><subject>Hemoglobin</subject><subject>Hepatitis</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin Glargine - therapeutic use</subject><subject>Leg - physiopathology</subject><subject>Male</subject><subject>Medical research</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Multiple myeloma</subject><subject>neuromuscular disease</subject><subject>orthopaedic and trauma surgery</subject><subject>Patients</subject><subject>peripheral nerve disease</subject><subject>Rare Disease</subject><subject>Spinal cord</subject><subject>Surgeons</subject><subject>Surgery</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkc1LwzAAxYMobsydvUnBi6h1-Wib5iLI_ISBFwVvIUlT19k2NW2F_vemdM4pCOaSkPzy8l4eAIcIXiBEoplU1scQMR8TxHC8A8aIhtSnDL7sbq1HYFrXK-gGQUEckH0w6vmAQjoGs-tMSN1kyhNFZxprqmV37pWm8TrTWq_pqkyJ3JNCvXmVyMoDsJeKvNbT9TwBz7c3T_N7f_F49zC_WvgyYLjxIy0TDBlK4hhFmigCVaqJJlDGEIeJpMLtpQkJacoowow4tzqOJNJIJiRmZAIuB92qlYVOlC4bK3Je2awQtuNGZPznSZkt-av54BELA_emEzhZC1jz3uq64UVWK53notSmrTkmJMIhhAFx6PEvdOWyly6eowIaYhSGveBsoJQ1dW11ujGDIO_74K4P3vfBhz7cjaPtDBv-6_cdcDoAslj9Q-3sG94Y_Iv-BFhBn3Y</recordid><startdate>20200109</startdate><enddate>20200109</enddate><creator>Na, Jonathan Seung Doe</creator><creator>Dittmar, Philip C</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200109</creationdate><title>Diabetic amyotrophy, not your typical back pain</title><author>Na, Jonathan Seung Doe ; Dittmar, Philip C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b492t-6ebd2091d8816e3c30cfe3e30b8025db7a3c3fd357f971293175e86b1e1bd3893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Atrophy</topic><topic>Back pain</topic><topic>Back Pain - etiology</topic><topic>Case reports</topic><topic>Diabetes</topic><topic>Diabetic Neuropathies - complications</topic><topic>Diabetic Neuropathies - drug therapy</topic><topic>Diagnosis, Differential</topic><topic>Electromyography</topic><topic>Family medical history</topic><topic>Glucose</topic><topic>Hemoglobin</topic><topic>Hepatitis</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Insulin Glargine - therapeutic use</topic><topic>Leg - physiopathology</topic><topic>Male</topic><topic>Medical research</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Multiple myeloma</topic><topic>neuromuscular disease</topic><topic>orthopaedic and trauma surgery</topic><topic>Patients</topic><topic>peripheral nerve disease</topic><topic>Rare Disease</topic><topic>Spinal cord</topic><topic>Surgeons</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Na, Jonathan Seung Doe</creatorcontrib><creatorcontrib>Dittmar, Philip C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Na, Jonathan Seung Doe</au><au>Dittmar, Philip C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diabetic amyotrophy, not your typical back pain</atitle><jtitle>BMJ case reports</jtitle><stitle>BMJ Case Rep</stitle><addtitle>BMJ Case Rep</addtitle><date>2020-01-09</date><risdate>2020</risdate><volume>13</volume><issue>1</issue><spage>e231928</spage><pages>e231928-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><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.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>31924707</pmid><doi>10.1136/bcr-2019-231928</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Atrophy Back pain Back Pain - etiology Case reports Diabetes Diabetic Neuropathies - complications Diabetic Neuropathies - drug therapy Diagnosis, Differential Electromyography Family medical history Glucose Hemoglobin Hepatitis Hospitals Humans Hypoglycemic Agents - therapeutic use Insulin Glargine - therapeutic use Leg - physiopathology Male Medical research Metabolism Middle Aged Multiple myeloma neuromuscular disease orthopaedic and trauma surgery Patients peripheral nerve disease Rare Disease Spinal cord Surgeons Surgery |
| title | Diabetic amyotrophy, not your typical back pain |
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