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Mayo Clin Proc Innov Qual Outcomes . Progressive Monoarticular Inflammatory Arthritis Following Influenza Vaccination

tetano

Editor, Senior Moderator
Mayo Clin Proc Innov Qual Outcomes


. 2020 Nov 6;5(1):204-209.
doi: 10.1016/j.mayocpiqo.2020.08.004. eCollection 2021 Feb.
Progressive Monoarticular Inflammatory Arthritis Following Influenza Vaccination


Laurel A Littrell[SUP] 1 [/SUP], Dean F Leslie[SUP] 2 [/SUP], Dennis Michael Bierle[SUP] 3 [/SUP], Doris E Wenger[SUP] 1 [/SUP]



Affiliations
Free PMC article

Abstract

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.

Keywords: CT, computed tomography; MRI, magnetic resonance imaging.
 
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