Aiman Zafar

University of Kansas, USA

Abstract Title:

Muscle Death by Diabetes: A Case of Diabetic Myonecrosis

Biography:

Dr. Aiman Zafar, MD, is a board-certified endocrinologist with over 15 years of clinical experience with a strong commitment to providing evidence-based, compassionate care in the diagnosis and management of hormonal and metabolic disorders. With extensive training in internal medicine and endocrinology, Dr. Zafar specializes in treating a wide range of endocrine conditions, including diabetes, thyroid disorders, adrenal and pituitary diseases, bone disorders, and hormonal imbalances.
Fluent in English, Urdu, Punjabi, and Hindi, Dr. Zafar is known for building strong, trusting relationships with patients from diverse backgrounds. She brings a culturally sensitive and inclusive approach to care, ensuring that communication and treatment decisions are always patient-centered.
Dr. Zafar has a particular interest in challenging and complex cases, finding them intellectually stimulating and professionally rewarding. This passion drives her commitment to continuous learning and clinical excellence.
Actively engaged in ongoing medical education, Dr. Zafar stays current with the latest advancements in endocrinology and is involved in resident and fellow education.

Research Interests:

Introduction: Diabetic myonecrosis is a rare complication of poorly controlled diabetes affecting those with advanced microvascular disease. Case Presentation: A 64-year-old Caucasian male with severe obesity and long-standing type 2 diabetes and associated diabetic nephropathy, polyneuropathy, left below-knee amputation, and peripheral vascular disease presented with a 3-day history of sudden, sharp pain and swelling in the right leg and foot without preceding leg injury. Vitals were normal on exam. There was severe edema and erythema in the right leg. Labs notable for: leukocytosis, elevated ESR and CRP, AKI, elevated CK of 9300 U/L, and HbA1C 7.2%. A contrast MRI of the leg showed intramuscular edema and marked muscle enlargement. Antibiotics were discontinued once blood cultures were negative. Swelling and erythema of the right leg improved within a week with rest, compression wraps, leg elevation, allowing weight-bearing before discharge. Discussion: Diabetic?myonecrosis is a rare complication of long-standing diabetes presenting as acute muscle swelling, pain in the thigh/calf, without preceding trauma or systemic symptoms. Patients typically have normal white blood cell counts and elevated ESR and CRP in approximately 50% of cases. Diagnosis is clinical, supported by MRI, which shows muscle edema and infarction without abscess. The pathogenesis appears to be related to diabetic microangiopathy, with thickening of small-artery walls and fibrinoid occlusion, leading to muscle ischemia and subsequent necrosis. The condition is self-limiting, but recurrence may occur in 50 % of cases. Treatment is supportive—rest, analgesia, antiplatelet therapy, and optimization of glycemic control. Conclusion: Diabetic myonecrosis indicates advanced microvascular disease, with high recurrence and poor prognosis, best managed by rigorous risk factor control. Key Words: diabetes, leg swelling, leg pain, muscle edema, myonecrosis