Shoulder injury related to vaccine administration
Shoulder injury related to vaccine administration (SIRVA) describes the injury that occurs when there is an unintentional injection of antigenic material in the synovial tissues resulting in an inflammatory reaction.
After a vaccine administration, mostly on the first day, the patient feels a sharp pain associated with a limited and painful range of motion 1.
The proposed mechanism of action is an immune-mediated inflammatory reaction 1.
On MR imaging, the most common finding is fluid signal in the deep muscular or tendinous structures which can be associated with inflammatory changes in the subacromial-subdeltoid bursa and focal bone marrow edema of the humeral head 2.
In the worst cases, the injury might progress to osteonecrosis of the humeral head 3.
Treatment and prognosis
Most of the patients need at least one intra-articular corticosteroid injection, and the most severe cases are treated with surgery 1.
- 1. Atanasoff S, Ryan T, Lightfoot R, Johann-Liang R. Shoulder injury related to vaccine administration (SIRVA). (2010) Vaccine. 28 (51): 8049-52. doi:10.1016/j.vaccine.2010.10.005 - Pubmed
- 2. Gokcan Okur, Kimberly A. Chaney, Laurie M. Lomasney. Magnetic resonance imaging of abnormal shoulder pain following influenza vaccination. Skeletal Radiology. 43 (9): 1325. doi:10.1007/s00256-014-1875-9
- 3. Kuether G, Dietrich B, Smith T, Peter C, Gruessner S. Atraumatic osteonecrosis of the humeral head after influenza A-(H1N1) v-2009 vaccination. (2011) Vaccine. 29 (40): 6830-3. doi:10.1016/j.vaccine.2011.07.052 - Pubmed