Two patients with insulin dependent diabetes mellitus developed recurr
ent episodes of focal muscle pain and swelling. Clinical evaluation, m
agnetic resonance imaging (MRI) and muscle biopsy confirmed the diagno
sis of recurrent hemorrhagic muscle infarctions. Our studies suggest t
hat muscle infarction occurred because of hypercoagulability and assoc
iated vascular endothelial damage. Based on these findings we recommen
d long-term anticoagulation to prevent recurrent infarction.