Levin B E, Engel W K
JAMA. 1975 Nov 10;234(6):621-4. doi: 10.1001/jama.234.6.621.
Three patients had iatrogenic muscle fibrosis, without weakness or sensory loss. Deltoid muscle fibrosis produced the unique clinical sign of gradual, involuntary, and irreducible arm levitation. The third patient had both levitated arms and levitated legs, a result of injections in the rectus femoris muscles. Repeated intramuscular injections apparently resulted in muscle fibrosis and intramuscular nerve-twig damage. Pentazocine (Talwin) is a particularly offending agent. One patient showed an unusual tissue reaction to foreign material, which may have played a role in her muscle fibrosis. Nevertheless, dramatic recovery of muscle function followed surgical sectioning of the fibrous deltoid bands.
三名患者出现医源性肌肉纤维化，无肌无力或感觉丧失。三角肌纤维化产生了逐渐、不自主且不可复位的手臂抬起这一独特临床体征。第三名患者双臂和双腿均出现抬起，这是股直肌注射的结果。反复肌肉注射显然导致了肌肉纤维化和肌内神经小分支损伤。喷他佐辛（镇痛新）是一种特别有害的药物。一名患者对外来物质表现出异常的组织反应，这可能在其肌肉纤维化中起了作用。尽管如此，对纤维化的三角肌束带进行手术切断后，肌肉功能显著恢复。
