Shoulder Pain Reaction During A Pandemic

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Shoulder Pain Reaction During A Pandemic - Page #4

Working Diagnosis: Reactive Lymphadenopathy with History of Recurrent Shoulder Subluxation Treatment: Her symptoms improved over the course of weeks with a structured home exercise program. Outcome: On follow up office examination and imaging review, no axillary lymphadenopathy was palpable. No side effects to COVID-19 vaccination were reported. Good compliance was reported with home exercise program. Left shoulder strength had improved, and there was no apprehension during range of motion testing. Author's Comments: This case illustrates the incidental finding of lymphadenopathy in setting of recent COVID-19 immunization on shoulder MRI. Case Photo #2 This has been well recognized in oncology literature, but not frequently reported in MSK literature. Editor's Comments: For sports medicine physicians (who order, perform and review imaging studies), this case is an important reminder of patient history in imaging interpretation. Palpable ipsilateral axillary lymphadenopathy has been reported in 10-15% of patients following Covid-19 vaccination (1). Recommendations have been made to share recent vaccine history with the radiologist, to defer imaging (if possible) for 4-6 weeks following vaccination, and to follow up persistent palpable axillary lymphadenopathy at 6 weeks with axillary ultrasound (1)(2). References: 1. Lehman CD, D'Alessandro HA, Mendoza DP, Succi MD, Kambadakone A, Lamb LR. Unilateral Lymphadenopathy After COVID-19 Vaccination: A Practical Management Plan for Radiologists Across Specialties. J Am Coll Radiol. 2021 Jun;18(6):843-852. doi: 10.1016/j.jacr.2021.03.001. Epub 2021 Mar 4. PMID: 33713605; PMCID: PMC7931722. 2. Keshavarz P, Yazdanpanah F, Rafiee F, Mizandari M. Lymphadenopathy Following COVID-19 Vaccination: Imaging Findings Review. Acad Radiol. 2021 Aug;28(8):1058-1071. doi: 10.1016/j.acra.2021.04.007. Epub 2021 May 1. PMID: 33985872; PMCID: PMC8088218. Return To The Case Studies List.		Back
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