Adhesive Capsulitis Following Improper Tetanus-Diphtheria (Td) Booster Administration

Area of Science:

• Orthopedics
• Immunology
• Sports Medicine

Background:

• Adhesive capsulitis is a shoulder condition characterized by stiffness and pain.
• Shoulder Injury Related to Vaccine Administration (SIRVA) encompasses various shoulder pathologies resulting from incorrect vaccine injection.
• Improper intramuscular deltoid vaccine administration can lead to needle placement errors, affecting joint structures.

Observation:

• A previously healthy middle-aged female developed left shoulder pain and stiffness after a tetanus-diphtheria (Td) booster vaccination.
• The patient reported the injection was administered higher than usual in the deltoid muscle.
• Symptoms progressed over two weeks, leading to significant loss of shoulder range of motion.

Findings:

• The patient was diagnosed with adhesive capsulitis four months after symptom onset.
• This represents the first reported case of adhesive capsulitis following an improper tetanus-diphtheria (Td) vaccine administration.
• The patient was referred for physical therapy but was lost to follow-up, leaving recovery status uncertain.

Implications:

• This case suggests a potential association between incorrect vaccine administration technique and the development of adhesive capsulitis.
• Further research is needed to understand the temporal course and recovery patterns of vaccine-induced adhesive capsulitis compared to classic adhesive capsulitis.
• Clinicians should be aware of SIRVA as a differential diagnosis in patients presenting with shoulder pain and stiffness post-vaccination.