Focal myopathy induced by chronic heroin injection is reversible

We report a patient who developed a focal myopathy with prominent contractu res of his thigh muscles induced by chronic heroin injection. Muscle biopsy and magnetic resonance imaging (MRI) were indicative of a fibrotic and inf lammatory process. Treatment with steroids, D-penicillamine, and physical t herapy led to full functional recovery within 6 months. Sequential electrom yographic (EMG) studies and muscle biopsies showed evidence of regenerating muscle fibers and absence of inflammatory cells. We conclude that heroin-i nduced focal myopathy is reversible and that combination therapy with D-pen icillamine and steroids may be useful. (C) 2000 John Wiley & Sons, Inc.