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Case of the Week 22 2015

*9-mount-old male baby with swelling in his right thigh.

What is the most likely diagnosis?

1. Intramuscular hematoma
2. Intramuscular abscess
3. Intramuscular mass
4. Muscle tear

Answer

Answer: Intramuscular hematoma secondary to vaccination

Case Discussion:

US and Doppler US images demonstrate normal right thigh muscles and well-defined hypoechoic mass in right vastus intermedius muscle (arrow) and no vascularity.

Intramuscular hematoma is described as a collection of blood within a muscle. Intramuscular hematoma can be related to intra-muscular injections. Other complications of intramuscular injections include; abscess, injury to blood vessels and peripheral nerves, pain at the injection site, infection, bleeding, and allergic reaction.

References:
1. Beecroft PC , Redick S .Possible complications of intramuscular injections in the pediatric unit. Pediat Nurs 1989; 15:333-6