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Papers of the Week

2020 Feb 12

Mil Med



Treating SIRVA Early With Corticosteroid Injections: A Case Series.


Macomb CV, Evans MO, Dockstater JE, Montgomery JR, Beakes DE
Mil Med. 2020 Feb 12; 185(1-2):e298-e300.
PMID: 31621851.


Shoulder injury related to vaccine administration (SIRVA) is defined as "shoulder pain with limited range of motion within 48 hours after vaccine receipt in individuals with no prior history of pain, inflammation, or dysfunction of the affected shoulder before vaccine administration." Corticosteroid injections (CSIs) have been proposed as a reasonable treatment modality for SIRVA, although evidence regarding efficacy is scanty. In this case series, we present two patients diagnosed with SIRVA who received CSI within 5 days of symptom onset and saw symptom resolution within 1 month. This is in comparison to a Centers for Disease Control and Prevention report that showed 65% of patients with SIRVA will have pain lasting longer than 1 month, and 25% will have pain lasting longer than 3 months. Our case series shows that CSIs may be an effective treatment modality for SIRVA. It would be reasonable to use CSIs as a first line treatment and should especially be considered in patients who have contraindications to nonsteroidal anti-inflammatory drugs.