Intramuscular injections into the buttocks: are they truly intramuscular?
OBJECTIVE
To radiologically determine if intramuscular (IM) injections into the buttocks are truly intramuscular.


METHODS
This was a prospective study conducted during a 6 month period beginning in October 2004. Fifty inpatients were recruited from a single tertiary referral hospital. Approval was obtained from the hospital research ethics committee and informed written consent was acquired from all participants. Prior to computerised tomography (CT), each patient received an IM injection of their prescribed medication along with 1 mL of air into the upper outer quadrant of the buttocks. CT images were subsequently analyzed by two radiologists to determine the position of the injected air bubble and to assess whether it was intramuscular or subcutaneous in position. Body mass index (BMI), distance to injection site, subcutaneous fat and muscle thickness were also measured.


RESULTS
Overall, only 32% (n=16/50) of patients had intramuscular injections, with the majority of injections (68%, n=34/50) being subcutaneous. When analysed by gender, 56% (n=14/25) of males had intramuscular injections while in females, the efficacy rate was significantly lower at 8% (n=2/25).


CONCLUSIONS
The majority of assumed intramuscular injections are actually subcutaneous.
Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
V O
VO
Chan
J
J
Colville
T
T
Persaud
O
O
Buckley
S
S
Hamilton
W C
WC
Torreggiani
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D015992:Body Mass Index; D002081:Buttocks / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods / Q000706:statistics & numerical data; D007279:Injections, Subcutaneous / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D017678:Sex Distribution; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods