Contractures and Drug Abuse

Contracture is limitation of complete range of motion,active or passive, due to joint, muscle or soft-tissuelimitations. Myogenic contractures can be due to trauma,inflammation, degenerative changes, ischemia, andspasticity. A 32-year-old patient presented with complaintsof inability to sit on the floor and limitation of multiplejoint movements which progressed over the past threeyears. He had a history of multiple drug injections(pentazocine) for the past six years at multiple sitesthroughout the body. He was started on narcoticanalgesics for chronic abdominal pain followingpancreatitis. Deltoid, quadriceps, hamstring and calfmuscles were indurated and contracted. Bilateral wingingof scapula was present. Contractures are commonlyassociated with joint diseases; but normal radiographsand indurated muscles support a myogenic pathology inthis case. Myogenic contracture due to parenteral narcoticabuse is a rare entity.