[Calcifying granulomatous peritendinitis after local dexamethasone treatment]

Area of Science:

• Histopathology
• Dermatology
• Rheumatology

Background:

• Epicondylitis humeri radialis (tennis elbow) is often treated with corticosteroid injections.
• Soybean oil is sometimes used as a carrier agent in pharmaceutical preparations.

Observation:

• A 43-year-old male patient received two cortisone injections containing soybean oil for epicondylitis.
• Post-injection, surgically extracted necrotized fat tissue was submitted for histological analysis.

Findings:

• Histological examination revealed calcifying collagen fiber necrosis.
• A granulomatous reaction was observed, actively clearing the necrotic tissue.
• Resorption of necrotic collagen fibers by granulation tissue was evident.

Implications:

• Soybean oil, used as a drug carrier, may induce calcifying collagen fiber necrosis.
• This finding highlights a potential adverse reaction to corticosteroid injections with lipid-based carriers.
• Understanding such reactions is crucial for optimizing treatment strategies and patient safety.