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Intramuscular hematoma with motor weakness after trigger point injection: A case report
Sang Gyun Kim1, Kwang Seok Shim, Dong Won Lee
1Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea.
Medicine
|September 28, 2017
Summary
Trigger point injections can cause hematomas in patients taking clopidogrel, even though it is not a formal contraindication. Careful consideration is advised when performing this procedure on patients using antiplatelet medications.
Area of Science:
- Pain management
- Musculoskeletal medicine
- Interventional procedures
Background:
- Trigger point injection is generally considered a low-risk procedure.
- Patients with hemorrhagic disorders or on anticoagulants/antiplatelets typically have contraindications for trigger point injection.
- Clopidogrel use is not a universally defined contraindication for trigger point injection.
Observation:
- A 76-year-old woman on regular clopidogrel presented with chronic low back and buttock pain.
- The patient was diagnosed with lumbar spinal stenosis and referred for epidural steroid injection.
- She underwent trigger point injection for her pain.
Findings:
- Within three hours post-injection, the patient developed motor weakness and localized pain.
- Ultrasonography revealed a hematoma in the gluteus medius muscle.
- Ultrasound-guided needle aspiration successfully relieved the patient's symptoms.
Implications:
- Trigger point injections in patients taking clopidogrel require heightened caution.
- Awareness of potential complications like hematoma formation is crucial.
- This case highlights the need for careful patient selection and procedural consideration in patients on antiplatelet therapy.
