Bilateral Knee and Thigh Pain in a Woman With Uncontrolled Type 2 Diabetes

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A 50-year-old African American woman with type 2 diabetes mellitus and hypertension was admitted with bilateral knee and thigh pain and swelling of both knees. MRI showed extensive edema in the distal thigh and gastrocnemius muscles and in subcutaneous fat. Fluid was seen at the short head of the left biceps femoris. The findings were consistent with diabetic myonecrosis. Which of the following statements about this condition is/are true?

A 50-year-old African American woman with type 2 diabetes mellitus and hypertension was admitted with bilateral knee and thigh pain and swelling of both knees. MRI showed extensive edema in the distal thigh and gastrocnemius muscles and in subcutaneous fat. Fluid was seen at the short head of the left biceps femoris. The findings were consistent with diabetic myonecrosis.

Which of the following statements about this condition is/are true?

A. Diabetic myonecrosis is a rare complication of uncontrolled DM.
B. It affects patients with type 2 diabetes who present with thigh pain or knee effusions.
C. It may be unilateral or bilateral and usually affects the quadriceps muscle.
D. The differential includes trauma, septic arthritis, crystal arthropathy, and myositis.
E. All of the above are true.
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