Dynamic ultrasound evaluation and treatment of subcoracoid bursitis after HPV vaccination: a case of shoulder injury related to vaccine administration (SIRVA)

Abstract

Shoulder Injury Related to Vaccine Administration (SIRVA) is a complication caused by improperly administered vaccinations. It triggers an inflammatory cascade that damages shoulder structures, resulting in prolonged shoulder pain and restricted range of motion. Common diagnoses in SIRVA patients include shoulder bursitis (all classified as subacromial bursitis), adhesive capsulitis, and rotator cuff injuries such as tears or tendinopathy. Less frequent diagnoses include biceps tenosynovitis, shoulder synovitis, intramuscular hematoma, and polymyalgia rheumatica or polymyalgia rheumatica-like syndrome. We present a case of SIRVA with prominent subcoracoid bursitis, confirmed via ultrasound. Ultrasound plays a critical role in static and dynamic assessments, providing accurate diagnoses and valuable guidance for identifying associated pathologies and managing SIRVA.