Intended intramuscular gluteal injections: are they truly intramuscular?
BACKGROUND
In patients with obesity, intramuscular injections may be deposited subcutaneously due to an increase in gluteal fat. We aimed to use abdominal CT done in our institute for gluteal fat thickness to test our hypothesis.


METHODS
After IRB approval, CT scans of the abdomen and pelvis of the past 6 months were analyzed. The thickness of gluteal region subcutaneous fat was measured in a standardized manner.


RESULTS
Out of 700 CT scans, studied, 476 were males and 224 were females. The average gluteal fat thickness was 2.34 cm +/- 1 cm. The average fat thickness in males was 1.98 cm +/- 0.98 cm whereas in females was 3.0 cm +/- 1.2 cm. Subcutaneous granulomas were seen in 17 cases and one injection granuloma in the intramuscular plane.


CONCLUSIONS
A significant number of female patients had increased gluteal fat thickness beyond the reach of routinely used needles. The medications in these patients will thus be unintentionally injected to subcutaneous plane, possibly altering the pharmacokinetics.
Department of Radiology, Narayana Hrudayala and Muzumdar Cancer Center, Bangalore, Karnataka, India.
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Dayananda
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Belaval
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Raina
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Chandana
D000273:Adipose Tissue / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002081:Buttocks / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D005260:Female; D006099:Granuloma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods / Q000706:statistics & numerical data; D007279:Injections, Subcutaneous / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009339:Needles; D012189:Retrospective Studies; D017678:Sex Distribution; D012885:Skinfold Thickness; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult