Diabetic amyotrophy, not your typical back pain

BMJ Case Rep. 2020 Jan 9;13(1):e231928. doi: 10.1136/bcr-2019-231928.


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.

Keywords: diabetes; neuromuscular disease; orthopaedic and trauma surgery; peripheral nerve disease.

Publication types

  • Case Reports

MeSH terms

  • Back Pain / etiology*
  • Diabetic Neuropathies / complications*
  • Diabetic Neuropathies / drug therapy*
  • Diagnosis, Differential
  • Electromyography
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin Glargine / therapeutic use*
  • Leg / physiopathology
  • Male
  • Middle Aged


  • Hypoglycemic Agents
  • Insulin Glargine