Littrell Laurel A, Leslie Dean F, Bierle Dennis Michael, Wenger Doris E
Department of Radiology, Mayo Clinic, Rochester, MN.
Clinical Radiologists, Springfield, IL.
Mayo Clin Proc Innov Qual Outcomes. 2020 Nov 6;5(1):204-209. doi: 10.1016/j.mayocpiqo.2020.08.004. eCollection 2021 Feb.
Musculoskeletal injury is an uncommon but usually self-limited complication of vaccine administration. We present a case of progressive inflammatory monoarthritis of the shoulder characterized by bone erosion, bursitis, and severe synovitis caused by an influenza vaccine administered to the ipsilateral deltoid region. Clinical symptoms began within 2 hours of vaccination, with progressive decline in function over 6 weeks. Magnetic resonance imaging examinations performed 5 months apart demonstrated progressive erosive changes of the greater tuberosity, rotator cuff injury, and extensive enhancing synovitis of the glenohumeral joint and subacromial/subdeltoid bursa. After the exclusion of septic arthritis and osteomyelitis, the patient underwent nonoperative treatment and experienced near-complete recovery at 32 months. Although inflammatory arthritis of the shoulder following vaccination is rare, there have been previous reports of it. Clinicians and radiologists need to be aware of this potential complication to ensure an accurate diagnosis.
肌肉骨骼损伤是疫苗接种后一种不常见但通常自限性的并发症。我们报告一例肩部进行性炎症性单关节炎病例，其特征为骨侵蚀、滑囊炎和严重滑膜炎，由接种于同侧三角肌区域的流感疫苗引起。临床症状在接种后2小时内出现，功能在6周内逐渐下降。相隔5个月进行的磁共振成像检查显示，大结节有进行性侵蚀性改变、肩袖损伤以及肱盂关节和肩峰下/三角肌下滑囊广泛强化的滑膜炎。排除化脓性关节炎和骨髓炎后，患者接受了非手术治疗，并在32个月时几乎完全康复。虽然接种疫苗后肩部炎症性关节炎很少见，但之前已有相关报道。临床医生和放射科医生需要意识到这种潜在并发症，以确保准确诊断。
