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. <a href="CaseStudyImages/CS2CS1ShoulderPainRe-991.jpg" title="Case Photo #2" data-lity><b>Case Photo #2</b></a> This has been well recognized in oncology literature, but not frequently reported in MSK literature. Editor's Comments: For sports medicine physicians <br>(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. <br> <br>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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