# A Case of Bilateral Acro-Osteolysis Following Osteomyelitis in a Patient With Type 2 Diabetes Mellitus and a Literature Review on Acro-Osteolysis

## TL;DR

A diabetic patient developed bone loss in his fingers and toes after a long-term bone infection, highlighting the need for early diagnosis and teamwork in treatment.

## Contribution

Presents a rare case linking acro-osteolysis to diabetes and osteomyelitis, emphasizing diagnostic challenges in such patients.

## Key findings

- Bilateral acro-osteolysis occurred in a type 2 diabetic patient with chronic osteomyelitis.
- Autoimmune and vascular causes were ruled out, supporting infection-related acro-osteolysis.
- Early recognition and multidisciplinary care are essential to prevent disability.

## Abstract

Acro-osteolysis is a rare condition characterised by progressive resorption of the distal phalanges, often associated with systemic diseases, neuropathy, or vascular dysfunction. While commonly linked to autoimmune and rheumatic conditions, its occurrence in diabetic patients following osteomyelitis is infrequent.

We present a case of bilateral acro-osteolysis in a male in his mid-70s with type 2 diabetes mellitus and a history of chronic osteomyelitis. Despite appropriate antimicrobial management, the patient exhibited ongoing bone resorption in both feet. A comprehensive autoimmune and vascular workup ruled out alternative causes, supporting the diagnosis of acro-osteolysis secondary to chronic infection.

This case highlights the diagnostic challenges and potential mechanisms of acro-osteolysis in diabetic patients. Early recognition and a multidisciplinary approach are crucial to preventing functional disability.