Ultrasonic aspiration for vaccination-related shoulder dysfunction

Background: Chronic shoulder pain occurs rarely after a vaccination and is hypothesized to arise from the effects of unintentional vaccine injection into the subacromial bursa, rotator cuff, capsule or underlying bone. The avascular nature of the rotator cuff, as well as unknown genetic and environm...

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Autores principales:	Marko Bodor, Yvette Uribe, Uma Srikumaran
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Shoulder Vaccination Pain Dysfunction Ultrasound Infraspinatus Science (General) Q1-390 Social sciences (General) H1-99
Acceso en línea:	https://doaj.org/article/e7160b41b9aa4a4885e67c2a240ec7b9
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spelling	oai:doaj.org-article:e7160b41b9aa4a4885e67c2a240ec7b92021-12-02T05:03:14ZUltrasonic aspiration for vaccination-related shoulder dysfunction2405-844010.1016/j.heliyon.2021.e08442https://doaj.org/article/e7160b41b9aa4a4885e67c2a240ec7b92021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2405844021025457https://doaj.org/toc/2405-8440Background: Chronic shoulder pain occurs rarely after a vaccination and is hypothesized to arise from the effects of unintentional vaccine injection into the subacromial bursa, rotator cuff, capsule or underlying bone. The avascular nature of the rotator cuff, as well as unknown genetic and environmental factors, may predispose to the persistence of pain and disability, referred to as vaccination-related shoulder dysfunction and shoulder injury related to vaccine administration (SIRVA). Methods: Ultrasonography, sonopalpation and ultrasound-guided anesthetic injections were used to locate the anatomical source of chronic (mean 20, range 8–42 months) shoulder pain after a vaccination in a consecutive series of 5 patients. Subsequently ultrasound-guided ultrasonic aspiration and debridement was performed using a 2.1 mm outer cannula with an inner needle vibrating at 28 kHz. Outcomes were assessed using the Quick Disabilities of the Arm, Shoulder and Hand (QDASH) scale at 2, 4, 12, 24 weeks and 1 year. Results: The distal infraspinatus and teres minor tendons, their insertions and or the adjacent bone were the source of pain in all 5 patients. The mean QDASH score improved from 65 points to 11 points at 2 weeks (P = 0.001), and to 1 point at 4 weeks after the procedures (P = 0.003). Improvements in pain and function remained stable at 1 year in 3 patients, for at least 24 weeks in 1 patient who died of unrelated causes, and 1 year in 1 patient for posterior shoulder pain who after a pain free interval developed anterior shoulder pain related to his previously asymptomatic osteoarthritis (P = 0.013). Conclusion: The distal infraspinatus and teres minor tendons, their insertions and adjacent bone are a common source of chronic shoulder pain after a vaccination. Ultrasound-guided ultrasonic aspiration and debridement is a potentially effective treatment for resolving pain and restoring function.Marko BodorYvette UribeUma SrikumaranElsevierarticleShoulderVaccinationPainDysfunctionUltrasoundInfraspinatusScience (General)Q1-390Social sciences (General)H1-99ENHeliyon, Vol 7, Iss 11, Pp e08442- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Shoulder Vaccination Pain Dysfunction Ultrasound Infraspinatus Science (General) Q1-390 Social sciences (General) H1-99
spellingShingle	Shoulder Vaccination Pain Dysfunction Ultrasound Infraspinatus Science (General) Q1-390 Social sciences (General) H1-99 Marko Bodor Yvette Uribe Uma Srikumaran Ultrasonic aspiration for vaccination-related shoulder dysfunction
description	Background: Chronic shoulder pain occurs rarely after a vaccination and is hypothesized to arise from the effects of unintentional vaccine injection into the subacromial bursa, rotator cuff, capsule or underlying bone. The avascular nature of the rotator cuff, as well as unknown genetic and environmental factors, may predispose to the persistence of pain and disability, referred to as vaccination-related shoulder dysfunction and shoulder injury related to vaccine administration (SIRVA). Methods: Ultrasonography, sonopalpation and ultrasound-guided anesthetic injections were used to locate the anatomical source of chronic (mean 20, range 8–42 months) shoulder pain after a vaccination in a consecutive series of 5 patients. Subsequently ultrasound-guided ultrasonic aspiration and debridement was performed using a 2.1 mm outer cannula with an inner needle vibrating at 28 kHz. Outcomes were assessed using the Quick Disabilities of the Arm, Shoulder and Hand (QDASH) scale at 2, 4, 12, 24 weeks and 1 year. Results: The distal infraspinatus and teres minor tendons, their insertions and or the adjacent bone were the source of pain in all 5 patients. The mean QDASH score improved from 65 points to 11 points at 2 weeks (P = 0.001), and to 1 point at 4 weeks after the procedures (P = 0.003). Improvements in pain and function remained stable at 1 year in 3 patients, for at least 24 weeks in 1 patient who died of unrelated causes, and 1 year in 1 patient for posterior shoulder pain who after a pain free interval developed anterior shoulder pain related to his previously asymptomatic osteoarthritis (P = 0.013). Conclusion: The distal infraspinatus and teres minor tendons, their insertions and adjacent bone are a common source of chronic shoulder pain after a vaccination. Ultrasound-guided ultrasonic aspiration and debridement is a potentially effective treatment for resolving pain and restoring function.
format	article
author	Marko Bodor Yvette Uribe Uma Srikumaran
author_facet	Marko Bodor Yvette Uribe Uma Srikumaran
author_sort	Marko Bodor
title	Ultrasonic aspiration for vaccination-related shoulder dysfunction
title_short	Ultrasonic aspiration for vaccination-related shoulder dysfunction
title_full	Ultrasonic aspiration for vaccination-related shoulder dysfunction
title_fullStr	Ultrasonic aspiration for vaccination-related shoulder dysfunction
title_full_unstemmed	Ultrasonic aspiration for vaccination-related shoulder dysfunction
title_sort	ultrasonic aspiration for vaccination-related shoulder dysfunction
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/e7160b41b9aa4a4885e67c2a240ec7b9
work_keys_str_mv	AT markobodor ultrasonicaspirationforvaccinationrelatedshoulderdysfunction AT yvetteuribe ultrasonicaspirationforvaccinationrelatedshoulderdysfunction AT umasrikumaran ultrasonicaspirationforvaccinationrelatedshoulderdysfunction
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Ultrasonic aspiration for vaccination-related shoulder dysfunction

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