Injection Fibrosis / Quadriceps Contracture

I created this site to try to find people who have the same problem as me, and to provide a place to collect medical information.

It's a very rare problem that most doctors (at least in the United States) haven't heard of. Ever since I was young, I haven't been able to bend my knees all the way. When I was younger I could bend them 80 to 90 degrees -- now it's more like 40 to 60. For me, there don't seem to be that many other complications, and I have no pain or anything like that.

I'm not even sure what you're supposed to call it, so I just borrowed the terms injection fibrosis and quadriceps contracture from the academic papers below.

I get a pretty steady trickle of traffic, and I've even gotten a few e-mails from people with similar problems! Please see my blog for details!

Feel free to contact me at andy@injectionfibrosis.org if you or anybody you know has this condition.

Here are some academic papers I've collected from the web. If you can help me fill in any of the blanks, that would also help.

Title (pdf) Links Authors Year Journal
Clinical Manifestations and Pathomechanics of Contracture of the Extensor Mechanism of the Knee (pdf) original / Google / Scholar Bose, K and Chong, KC 1976 J Bone Joint Surg Br
Experience with thirty-eight Asian children and adolescents who presented with either stiffness of the knee, genu recurvatum, habitual dislocation of the patella or congenital lateral dislocation of the patella showed that all those disorders were manifestations of contracture of the extensor mechanism, which fell into two groups according to the components involved. ...
Congenital Contracture of the Quadriceps Muscle - confirming the diagnosis with magnetic resonance imaging (pdf) Google / Scholar      
Congenital Contracture of the Quadriceps Muscle: FOUR CASE REPORTS IN IDENTICAL TWINS (pdf) original / Google / Scholar CHIU, SHONG SHOW and FURUY ... 1974 J Bone Joint Surg Am
Congenital Fibrosis of the Vastus Intermedius Muscle (pdf) original / Google / Scholar Karlen, A. 1964 J Bone Joint Surg Br
1. The cases of six Chinese children affected by so-called congenital fibrosis of the vastus intermedius muscle are described. The reasons for the choice of name are discussed. ...
Congenital contracture of the quadriceps muscle: a case report with magnetic resonance imaging (pdf) original / Google / Scholar Yamamuro, Takao 2004 Archives of Orthopaedic and Trauma Surgery
Introduction Case report of a rare form of congenital contracture of the quadriceps muscle. Congenital contracture of the quadriceps muscle is encountered very rarely in daily orthopaedic practice. ...
Contracture of the Deltoid Muscle: Sonographic Evaluation with MRI Correlation (pdf) original / Google / Scholar Huang, Chung-Cheng and Ko, ... 2005 Am. J. Roentgenol.
OBJECTIVE. This article evaluates the sonographic features of deltoid contracture (DC) with MRI correlation. MATERIAL AND METHODS. Two reviewers evaluated the imaging features in 22 painful shoulders of 20 patients with a sonographic diagnosis of DC and a subsequent confirming MRI study. ...
Contracture of the Quadriceps Muscle (pdf) original / Google / Scholar Gunn, D. R. 1964 J Bone Joint Surg Br
1. Contracture of parts of the quadriceps muscle is not uncommon and is often accompanied by tightness of the ilio-tibial tract. It is suggested that this may follow intramuscular injections. ...
Contracture of the Vastus Intermedius in Children (pdf) original / Google / Scholar Gammie, W. F. P. and Taylo ... 1963 J Bone Joint Surg Br
1. Two patients are reported with progressive fibrosis of the vastus intermedius muscle causing limitation of flexion of the knee. The first patient, a girl of ten years who was one of binovular twins, noticed difficulty in walking at the age of five, the disability increasing with age. ...
Contracture of the quadriceps muscle caused by injection (missing) Google / Scholar      
Fibrous contracture of muscles following intramuscular injections in adults (missing) Google / Scholar      
Habitual Dislocation of the Patella in Flexion (pdf) original / Google / Scholar Bergman, NR and Williams, PF 1988 J Bone Joint Surg Br
Thirty-five patients with habitual dislocation of the patella in flexion were reviewed; eight were bilaterally affected. Each had undergone quadricepsplasty with an average follow-up of 6 years 9 months. ...
Infantile quadriceps-femoris contracture resulting from intramuscular injections (missing) Google / Scholar      
Injection Fibrosis in the Quadriceps Femoris Muscle in Children (pdf) original / Google / Scholar Mukherjee, PK and Das, AK 1980 J Bone Joint Surg Am
Injection-induced Contractures of the Quadriceps in Childhood (pdf) original / Google / Scholar Jackson, AM and Hutton, PA 1985 J Bone Joint Surg Br
Thirty-two contractures of the quadriceps induced by injection in 17 children have been reviewed. The average age at presentation was 3 years 4 months. ...
Injection-induced Fibrosis of the Quadriceps Femoris Muscle in Children (pdf) Google / Scholar      
Intramuscular Injections in Children (missing) original / Google / Scholar Bergeson, Paul S. and Sing ... 1982 Pediatrics
The most common serious complications of intramuscular injections in children are muscle contractures and nerve injury. Muscle contracture occurs most commonly after injections in the anterior and lateral thigh, and sciatic nerve injury is the most frequently reported serious complication of the gluteal area. ...
Long-term Follow-up Results of Surgical Treatment for Patients with Quadriceps Contractures by Intramuscular Injection (missing) original / Google / Scholar      
MRI Diagnosis of Contracture of the Gluteus Maximus Muscle (pdf) original / Google / Scholar Chen, Clement K. H. and Ye ... 2006 Am. J. Roentgenol.
OBJECTIVE. The objective of our study was to describe MRI features of contracture of the gluteus maximus muscle after providing a retrospective review of the MRI studies of 21 patients. CONCLUSION. Gluteal contracture manifests characteristic features on MRI, including an intramuscular fibrotic cord extending to the thickened distal tendon with atrophy of the gluteus maximus muscle and posteromedial displacement of the iliotibial tract. ...
Pathogenesis of quadriceps contracture in children and adolescence (author's transl) (missing) original / Google / Scholar Nemoto, F 1980 Nippon Seikeigeka Gakkai Zasshi
Forty-one limbs in 35 patients were examined about the findings concerning with quadriceps contracture at operation and moreover pathohistological examination was carried out for the whole length of the resected rectus femoris muscle in every patient in order to study pathogenesis of contracture of the quadriceps muscles. ...
Post-injection fibrosis of skeletal muscle: A clinical problem (pdf) original / Google / Scholar Shanmugasundaram, T. K. 1980 International Orthopaedics
A personal series of 169 cases of post-injection fibrosis of skeletal muscle consisting of 78 cases of deltoid fibrosis, 84 cases of quadriceps fibrosis, 6 cases of gluteal fibrosis and one case of triceps fibrosis are presented. ...
Postoperative Evaluation of Quadriceps Contracture in Children (pdf) Google / Scholar      
Progressive Fibrosis of the Quadriceps Muscles (pdf) original / Google / Scholar SAUNDERS, F. P. and HOEFNA ... 1965 J Bone Joint Surg Am
Limitation of flexion of the knees in a young girl was found to be caused by progressive fibrosis of the quadriceps muscles. The child had had many intra-muscular injections into the thighs in early infancy. ...
Progressive contracture of the quadriceps in children (missing) Google / Scholar      
Progressive fibrosis of the quadriceps muscle (pdf) original / Google / Scholar Boon, R L and Baildam, E 2004 Arch Dis Child
Quadriceps Contracture (pdf) original / Google / Scholar Williams, Peter F. 1968 J Bone Joint Surg Br
1. Previous reports of the role of the quadriceps in producing limitation of movement or dislocation of the patella have tended to implicate one particular part of the complex. Experience gained in thirty-five quadricepsplasties in children has shown that all parts of the quadriceps (except vastus medialis) and the ilio-tibial band also may play a part and that each of these must be attended to if a satisfactory result is to be obtained. ...
Quadriceps contracture as a result of multiple intramuscular injection (missing) original / Google / Scholar McCloskey, J. R. and Chung ... 1977 Am J Dis Child
Quadriceps fibrosis (missing) original / Google / Scholar Makhani, J. 1971 Indian Journal of Pediatrics
Quadriceps fibrosis secondary to intramuscular injections in the thigh is reported in a series of 20 children. The clinical
Quadriceps myofibrosis. A complication of intramuscular injections (pdf) original / Google / Scholar Alvarez, EV and Munters, M ... 1980 J Bone Joint Surg Am
Review of the literature on quadriceps fibrosis and study of 11 cases (missing) Google / Scholar      
Surgical treatment for quadriceps contracture in adult (missing) original / Google / Scholar      
The Etiology of Quadriceps Contracture in Children (pdf) original / Google / Scholar Lloyd-Roberts, G. C. and T ... 1964 J Bone Joint Surg Br
1. Six cases of quadriceps contracture in children are described. All were either premature or suffered severe illnesses soon after birth. ...
Treatment of severe iatrogenic quadriceps retraction in children (missing) original / Google / Scholar   2004  
Triceps Contracture Caused by Injections (pdf) original / Google / Scholar Babhulkar, SS 1985 J Bone Joint Surg Br
Eleven cases are reported of contracture of the triceps muscle following intramuscular injections. This occurred in one arm of each of 11 children aged from 6 to 13 years, all of whom had a definite history of repeated injections. ...
Vastus lateralis fibrosis in habitual patella dislocation: An MRI study in 28 patients (pdf) original / Google / Scholar Chang K-C. 2000 Acta Orthopaedica Scandinavica
We studied 28 patients with habitual or recurrent dislocation of the patella with MRI of both thighs. Apart from the 2 patients whose dislocation could be related to trauma, we found signs of fibrosis of the vastus lateralis muscle in all the affected limbs of the 26 patients with an insidious onset of dislocation. ...

If you know of any more relevant papers, please contact me at andy@injectionfibrosis.org. Thanks!