Tachon Syndrome: Rare Side Effect of Articular Injections of Corticosteroids. A Report of Two Cases

Epidural or intra-articular injections of corticosteroids are an option for the treatment of several pain conditions but are not without adverse effects. Here, we discuss a rare systemic side effect of this therapy: Tachon syndrome. We report two cases, a 64-year-old woman and a 43-year-old man, who presented with Tachon syndrome after receiving, respectively, a shoulder and a lumbar injection of cortivazol 3.75 mg/1.5 ml suspension for injection in pre-filled syringes. The indication for this therapy was, respectively, tendinopathy of the supraspinatus and a mechanical L5 lumbosciatica. A few minutes after receiving the injection, patients experienced acute low back pain, chest tightness, facial erythema and profuse sweating. All vital and biologic parameters were normal. In the first case, improvement was spontaneous and all symptoms resolved in 20 min. The second patient remained under observation and received an intravenous 'physiological' infusion. Both patients recovered fully and returned home. A causal relationship between the corticosteroid injections and the patients' symptoms was very likely because of the acute clinical presentation and the rapid improvement in the patients' conditions and that no further signs indicating other serious complications developed.