Chronic shoulder injury related to vaccine administration following coronavirus disease 2019 vaccination: a case report
Abstract Background Shoulder injury related to vaccine administration, defined as shoulder pain and limited range of motion occurring after administration in the upper arm, has been previously reported. The symptom resolved completely after treatment with oral nonsteroidal anti-inflammatory drugs or...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13256-023-04198-0 |
| _version_ | 1797559476800192512 |
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| author | Masahiro Miyano Yukinori Tsukuda Shigeto Hiratsuka Masanari Hamasaki Norimasa Iwasaki |
| author_facet | Masahiro Miyano Yukinori Tsukuda Shigeto Hiratsuka Masanari Hamasaki Norimasa Iwasaki |
| author_sort | Masahiro Miyano |
| collection | DOAJ |
| description | Abstract Background Shoulder injury related to vaccine administration, defined as shoulder pain and limited range of motion occurring after administration in the upper arm, has been previously reported. The symptom resolved completely after treatment with oral nonsteroidal anti-inflammatory drugs or an intraarticular steroid injection, however there have been few reports of long-term symptoms following coronavirus disease 2019 vaccination. This case report describes a healthy, middle-aged, healthcare worker who developed post-vaccination subacromial–subdeltoid bursitis that lasted for more than 6 months after Pfizer–BioNTech coronavirus disease 2019 vaccination. Case presentation A 55-year-old Japanese woman with no significant medical history was vaccinated in the standard site, with the needle direction perpendicular to the skin. Within a few hours after the second vaccination, severe shoulder pain and limited range of motion appeared. Although shoulder range of motion improved, her shoulder pain did not improved for several months, and she consulted an orthopedic doctor 5 months later. Radiographs of her left shoulder did not provide helpful diagnostic information. High intensity in the subacromial–subdeltoid space was seen on short TI inversion recovery of magnetic resonance imaging, showing subacromial–subdeltoid bursitis. She was diagnosed with a shoulder injury related to vaccine administration. The patient was started on an oral anti-inflammatory drug, and the left subacromial space was injected with 2.5 mg of betamethasone with 3 ml of 1% lidocaine without epinephrine every 2 weeks. One month after starting this treatment, since her shoulder pain had not improved, the oral anti-inflammatory drug was switched to tramadol hydrochloride acetaminophen. However, 3 months after switching medication, the shoulder pain continued, and she worked so as to have minimal impact on her shoulder. Conclusion A case of subacromial–subdeltoid bursitis following a second dose of the Pfizer–BioNTech coronavirus disease 2019 vaccine that lasted many months is reported. Injection technique is a modifiable risk factor, the adverse effects of which could potentially be mitigated with appropriate and relevant training of healthcare providers. To prevent this type of case, the appropriate landmark, needle length, and direction should be confirmed. |
| first_indexed | 2024-03-10T17:45:58Z |
| format | Article |
| id | doaj.art-86bef4735d6a414cbb66eccdebf40738 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-03-10T17:45:58Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-86bef4735d6a414cbb66eccdebf407382023-11-20T09:32:04ZengBMCJournal of Medical Case Reports1752-19472023-10-011711510.1186/s13256-023-04198-0Chronic shoulder injury related to vaccine administration following coronavirus disease 2019 vaccination: a case reportMasahiro Miyano0Yukinori Tsukuda1Shigeto Hiratsuka2Masanari Hamasaki3Norimasa Iwasaki4Department of Orthopaedic Surgery, Otaru General HospitalDepartment of Orthopaedic Surgery, Otaru General HospitalDepartment of Orthopaedic Surgery, Otaru General HospitalDepartment of Orthopaedic Surgery, Otaru General HospitalDepartment of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityAbstract Background Shoulder injury related to vaccine administration, defined as shoulder pain and limited range of motion occurring after administration in the upper arm, has been previously reported. The symptom resolved completely after treatment with oral nonsteroidal anti-inflammatory drugs or an intraarticular steroid injection, however there have been few reports of long-term symptoms following coronavirus disease 2019 vaccination. This case report describes a healthy, middle-aged, healthcare worker who developed post-vaccination subacromial–subdeltoid bursitis that lasted for more than 6 months after Pfizer–BioNTech coronavirus disease 2019 vaccination. Case presentation A 55-year-old Japanese woman with no significant medical history was vaccinated in the standard site, with the needle direction perpendicular to the skin. Within a few hours after the second vaccination, severe shoulder pain and limited range of motion appeared. Although shoulder range of motion improved, her shoulder pain did not improved for several months, and she consulted an orthopedic doctor 5 months later. Radiographs of her left shoulder did not provide helpful diagnostic information. High intensity in the subacromial–subdeltoid space was seen on short TI inversion recovery of magnetic resonance imaging, showing subacromial–subdeltoid bursitis. She was diagnosed with a shoulder injury related to vaccine administration. The patient was started on an oral anti-inflammatory drug, and the left subacromial space was injected with 2.5 mg of betamethasone with 3 ml of 1% lidocaine without epinephrine every 2 weeks. One month after starting this treatment, since her shoulder pain had not improved, the oral anti-inflammatory drug was switched to tramadol hydrochloride acetaminophen. However, 3 months after switching medication, the shoulder pain continued, and she worked so as to have minimal impact on her shoulder. Conclusion A case of subacromial–subdeltoid bursitis following a second dose of the Pfizer–BioNTech coronavirus disease 2019 vaccine that lasted many months is reported. Injection technique is a modifiable risk factor, the adverse effects of which could potentially be mitigated with appropriate and relevant training of healthcare providers. To prevent this type of case, the appropriate landmark, needle length, and direction should be confirmed.https://doi.org/10.1186/s13256-023-04198-0Shoulder injury related to vaccine administration (SIRVA)COVID-19VaccineSubacromial–subdeltoid bursitisIntramuscular injection |
| spellingShingle | Masahiro Miyano Yukinori Tsukuda Shigeto Hiratsuka Masanari Hamasaki Norimasa Iwasaki Chronic shoulder injury related to vaccine administration following coronavirus disease 2019 vaccination: a case report Journal of Medical Case Reports Shoulder injury related to vaccine administration (SIRVA) COVID-19 Vaccine Subacromial–subdeltoid bursitis Intramuscular injection |
| title | Chronic shoulder injury related to vaccine administration following coronavirus disease 2019 vaccination: a case report |
| title_full | Chronic shoulder injury related to vaccine administration following coronavirus disease 2019 vaccination: a case report |
| title_fullStr | Chronic shoulder injury related to vaccine administration following coronavirus disease 2019 vaccination: a case report |
| title_full_unstemmed | Chronic shoulder injury related to vaccine administration following coronavirus disease 2019 vaccination: a case report |
| title_short | Chronic shoulder injury related to vaccine administration following coronavirus disease 2019 vaccination: a case report |
| title_sort | chronic shoulder injury related to vaccine administration following coronavirus disease 2019 vaccination a case report |
| topic | Shoulder injury related to vaccine administration (SIRVA) COVID-19 Vaccine Subacromial–subdeltoid bursitis Intramuscular injection |
| url | https://doi.org/10.1186/s13256-023-04198-0 |
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