title: Vaccination-related shoulder dysfunction.
abstract: We present two cases of shoulder pain and weakness following influenza and pneumococcal vaccine injections provided high into the deltoid muscle. Based on ultrasound measurements, we hypothesize that vaccine injected into the subdeltoid bursa caused a periarticular inflammatory response, subacromial bursitis, bicipital tendonitis and adhesive capsulitis. Resolution of symptoms followed corticosteroid injections to the subacromial space, bicipital tendon sheath and glenohumeral joint, followed by physical therapy. We conclude that the upper third of the deltoid muscle should not be used for vaccine injections, and the diagnosis of vaccination-related shoulder dysfunction should be considered in patients presenting with shoulder pain following a vaccination.
authors.affiliation: Queen of the Valley Hospital, Napa, CA 94558, USA. mbodor@post.harvard.edu
authors.forename: Marko
authors.initials: M
authors.lastname: Bodor
authors.forename: Enoch
authors.initials: E
authors.lastname: Montalvo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000009:adverse effects*; D008297:Male; D022242:Pneumococcal Vaccines / Q000009:adverse effects*; D012782:Shoulder / Q000503:physiopathology*; D020069:Shoulder Pain / Q000139:chemically induced* / Q000503:physiopathology*; D052256:Tendinopathy / Q000139:chemically induced / Q000175:diagnosis; D014611:Vaccination / Q000009:adverse effects*
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines