Injection granuloma

Case contributed by Dr Omar M. Sultan

Presentation

Patient complaining from left iliac crest pain.

Patient Data

Age: 50
Gender: Female
X-ray

Concerning patient complain, there is some widening of anterior part of left iliac crest mostly suggestive of left iliac crest apophysitis.

Bilateral calcific nodular shadow are incidentally seen in pelvis AP view, lateral to both iliac bones, changed in orientation in oblique view and appear superficial in  lateral view in the region of buttock.

Case Discussion

Injection granuloma is one of the most common finding in gluteal region. It could be single or multiple, unilateral or bilateral, and vary in size.

Post injection, a fat necrosis and dystrophic calcification take place resulting in calcific granuloma.

Subcutaneous (intra-fat) granuloma is much more common than intramuscular granuloma (93% vs 7%). This is due to that buttock subcutaneous fat thickness (5.7 +/- 1.8 cm for female vs 4.4 +/- 1.7 cm for male) exceeds the length of the most commonly used needle for intramuscular buttock injection (3.8 cm).

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Case information

rID: 37464
Case created: 9th Jun 2015
Last edited: 15th May 2016
Inclusion in quiz mode: Included

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