Persistent Shoulder Pain After Vaccine Administration Is Associated with Common Incidental Pathology: A Systematic Review

医学 荚膜炎 滑囊炎 肩袖 接种疫苗 肩袖损伤 肌腱病 物理疗法 梅德林 外科 病理 肌腱 运动范围 政治学 法学
作者
Erik L. Slette,Mitchell Rohrback,David Ring
出处
期刊:Clinical Orthopaedics and Related Research [Lippincott Williams & Wilkins]
卷期号:480 (7): 1251-1258 被引量:2
标识
DOI:10.1097/corr.0000000000002191
摘要

Claims of shoulder injury now account for half of all claims to the Vaccine Injury Compensation Program. Reports from databases of claims or potential adverse events note a relatively high mean age and high prevalences of rotator cuff tendinopathy and adhesive capsulitis-common shoulder problems that might be incidental to vaccination. Published case reports provide much more detail about individual patients than is available in databases. A review of published cases provides an opportunity for more detailed review of symptoms, diagnoses, pathology, treatment, and prognosis. Such a review can better assess the relative likelihood that pathologies associated with new persistent shoulder symptoms after vaccination are coincidental or unique to and caused by vaccine.Regarding published case reports addressing persistent shoulder pain after vaccination: (1) In what proportion of patients was a specific diagnosis made? (2) What diagnoses were most common? (3) Among patients treated nonsurgically, what proportion resolved, and over what time span did they resolve?In August 2020, we searched PubMed and Embase between 2006 and 2020 using the following search strategy: Search 1: (shoulder dysfunction OR shoulder pain OR shoulder bursitis OR rotator cuff tendonitis OR adhesive capsulitis OR glenohumeral arthritis AND [vaccine OR vaccination OR immunization]); Search 2: (shoulder injury related to vaccine administration or SIRVA). The search was supplemented by reviewing reference lists of identified studies. Inclusion criteria were any detailed report of three or fewer cases involving shoulder pain after vaccine administration. Twenty published reports of 29 patients were identified and assessed by two reviewers independently. One reported glenohumeral joint infection was excluded because the relationship between this type of relatively uncommon, discrete diagnosis and vaccination raises different considerations. We assumed a high risk of bias, although we are not aware of bias assessment tool for case reports. We recorded and summarized patient demographics, symptoms, examination and imaging findings, surgery findings, diagnoses, treatments, and outcomes. Seventy-five percent (21 of 28) of patients were women, with a mean age of 54 ± 19 years. In search of an underlying pathology, at least one diagnostic study was performed in 82% (23 of 28) of patients including radiographs in seven, ultrasound in seven, and MRI in 16 patients (some patients underwent more than one type of imaging). We distinguished specific pathophysiological diagnosis from shoulder pain and stiffness, counted the most common diagnoses among patients a specific diagnosis, and tracked symptom resolution among patients treated nonoperatively.A specific diagnosis was made in 57% (16 of 28) of patients. Twelve patients had pain and limitation of motion due to pain but no specific pathological diagnosis. The most common specific diagnoses were rotator cuff tendinopathy (9 of 16) and adhesive capsulitis (4 of 16). Less common specific diagnoses included rotator cuff arthropathy (and rheumatoid arthritis) and suspected septic arthritis with nonspecific synovitis on arthroscopy. One patient had transient MRI signal change in the humeral head, which was interpreted as osteonecrosis that resolved in a manner not typical for that diagnosis. Of the 17 patients treated nonsurgically, 15 reported resolution, and two had incomplete symptom resolution with the mean 6-month evaluation period.The observation that persistent shoulder pain after vaccination overlaps with common shoulder pathology-both in large databases as well as in more detailed reports of specific patients as analyzed in this review-establishes a high probability of a coincidental rather than a causal association. In the absence of high-quality experimental evidence of vaccine-specific shoulder pathology, in our opinion, it seems safest and healthiest to assume that perceived shoulder injury related to vaccine administration (SIRVA) is due to misinterpretation of new symptoms from established pathology rather than a new, vaccine-specific pathology.Level IV, therapeutic study.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
111完成签到,获得积分10
刚刚
微微完成签到,获得积分10
刚刚
刚刚
无语完成签到 ,获得积分10
刚刚
陶小陶完成签到,获得积分10
刚刚
刚刚
刚刚
研友_7ZebY8完成签到,获得积分10
1秒前
十万大山兵大大完成签到,获得积分10
1秒前
渊_完成签到,获得积分10
1秒前
123566完成签到,获得积分10
1秒前
flysky120完成签到,获得积分10
1秒前
1秒前
fox完成签到 ,获得积分10
1秒前
2秒前
NexusExplorer应助旭爸爸采纳,获得10
2秒前
smileriver完成签到,获得积分10
2秒前
吃水果的老虎完成签到,获得积分10
2秒前
Rahul完成签到,获得积分10
3秒前
勤恳的仰发布了新的文献求助10
3秒前
我独舞完成签到 ,获得积分10
3秒前
FIN应助hwq采纳,获得10
4秒前
一鸣大人发布了新的文献求助10
4秒前
cua完成签到,获得积分10
4秒前
BANG完成签到,获得积分10
4秒前
狄语蕊完成签到,获得积分10
4秒前
OccupyMars2025关注了科研通微信公众号
5秒前
朱凌娇发布了新的文献求助10
5秒前
珍珠糖发布了新的文献求助10
5秒前
优雅盼海发布了新的文献求助10
5秒前
沉淀完成签到,获得积分10
6秒前
科研助手6应助岳凯采纳,获得10
6秒前
kevin完成签到 ,获得积分10
6秒前
7秒前
7秒前
CCCCPUTA完成签到,获得积分10
8秒前
Haonan完成签到,获得积分10
8秒前
Refuel完成签到,获得积分10
8秒前
终梦发布了新的文献求助20
9秒前
积极的如之完成签到,获得积分10
9秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Social Research Methods (4th Edition) by Maggie Walter (2019) 2390
A new approach to the extrapolation of accelerated life test data 1000
北师大毕业论文 基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 390
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Robot-supported joining of reinforcement textiles with one-sided sewing heads 360
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4009167
求助须知:如何正确求助?哪些是违规求助? 3549013
关于积分的说明 11300491
捐赠科研通 3283494
什么是DOI,文献DOI怎么找? 1810370
邀请新用户注册赠送积分活动 886146
科研通“疑难数据库(出版商)”最低求助积分说明 811259