Iatrogenic axillary neuropathy after intramuscular injection of the deltoid muscle

Loren Davidson, Gregory T. Carter, David D. Kilmer, Jay J. Han

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

A previously healthy 26-yr-old male presented for an electrodiagnostic evaluation with complaints of significant right deltoid muscle atrophy and shoulder abduction weakness after receiving an intramuscular (IM) deltoid injection of an antiemetic 4 wk earlier. Electrodiagnostic evaluation confirmed an acute axillary neuropathy. We hypothesize that direct mechanical trauma to the anterior branch of the axillary nerve resulted in axillary mononeuropathy with axonal loss, although chemically induced nerve injury cannot be excluded. Injections in and about the shoulder complex are performed routinely for the purposes of vaccination, IM medication administration, deltoid trigger-point injections, and intra-articular and bursal steroid injections. Although such injections are considered routine office procedures, there is increased risk of neurovascular injury if they are performed incorrectly. The purpose of this brief report is to make practitioners aware of the potential for axillary neuropathy with such procedures, to review the salient anatomy, and to propose a potential guideline for clinical practice to minimize iatrogenic axillary neuropathy.

Original languageEnglish (US)
Pages (from-to)507-511
Number of pages5
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume86
Issue number6
DOIs
StatePublished - Jun 2007

Keywords

  • Axillary Nerve Anatomy
  • Axillary Neuropathy
  • IM Deltoid Injection
  • Shoulder Injection

ASJC Scopus subject areas

  • Rehabilitation
  • Health Professions(all)
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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