Figure 1: Skeletal muscle injury in patients with statin-associated myopathy. Light micrographs (A, B, D, E, F) and an electron micrograph (C) of transverse sections through the vastus lateralis muscle of patients with myopathy and current (B, D, E, F) or previous (A, C) statin use. Subsarcolemmal detachment of myofibrils is indicated by arrows in (A), (B) and (C). In (D), a ghost cell (g) is seen next to a developing split-fibre (arrows). (G, H): Light micrographs of semi-thin, transverse sections through the vastus lateralis muscle of myopathic patients currently (G) or formerly taking statins (H). Vacuolization is seen in most of the fibres (arrows). (I, J): The muscles fibres from control patients show no vacuolization. (K, L): Electron micrographs of a transverse section through the vastus lateralis muscle from a patient with myopathy who formerly used statins; intracellular vacuoles are present. The boxed area in (K) is enlarged in (L). The T-tubules are grossly vacuolated, but the adjacent mitochondria (m) have a normal appearance. Bars: A, B = 10 μm; C = 0.2 μm; D = 3 μm; E, F = 50 μm; G, I, J = 50 μm, H = 30 μm, K = 1 μm; L = 0.5 μm.