Shoulder Injury Related to Vaccine Administration (SIRVA) Following COVID-19 Vaccination: Correlating MRI Findings with Patient Demographics
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Data Collection
2.4. MRI Protocol
2.5. Follow-Up and Outcome Measures
2.6. Statistical Analysis
3. Results
3.1. Patient Demographics
3.2. Symptomatology of the First Vaccine Dose
3.3. Symptomatology of the Second Vaccine Dose
3.4. MRI Findings
3.5. MRI Findings and Associations
3.6. Persistence of Symptoms
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
SIRVA | Shoulder Injury Related to Vaccine Administration |
MRI | Magnetic resonance imaging |
BMI | Body mass index |
SASD | Subacromial/subdeltoid |
AC | Adhesive capsulitis |
Appendix A
Still Have Symptoms | |||
---|---|---|---|
No | Yes | p-Value | |
Age mean (SD) | 55.0 (8.0) | 49.1 (11.0) | 0.106 |
Age groups | 0.032 | ||
<55 years | 12 (44.4) | 7 (87.5) | |
≥55 Years | 15 (55.6) | 1 (12.5) | |
Gender | 0.032 | ||
Female | 12 (44.4) | 7 (87.5) | |
Male | 15 (55.6) | 1 (12.5) | |
BMI mean (SD) | 28.3 (4.4) | 29.0 (6.3) | 0.720 |
BMI categories | 0.441 | ||
Normal (18.5–24.9) | 6 (22.2) | 1 (12.5) | |
Overweight (25–29.9) | 10 (37) | 5 (62.5) | |
Obese (≥30) | 11 (40.7) | 2 (25) | |
Regular physical activity | 0.109 | ||
No | 17 (63) | 2 (25) | |
Sometimes | 7 (25.9) | 3 (37.5) | |
Yes | 3 (11.1) | 3 (37.5) | |
Diabetes | 0.020 | ||
No | 15 (55.6) | 8 (100) | |
Yes | 12 (44.4) | 0 (0) | |
Type of vaccine | 0.257 | ||
Pfizer | 14 (53.9) | 6 (75) | |
Sinopharm | 7 (26.9) | 0 (0) | |
AstraZeneca | 5 (19.2) | 2 (25) | |
Side injected | 0.025 | ||
Left | 15 (55.6) | 1 (12.5) | |
Right | 9 (33.3) | 7 (87.5) | |
Both | 3 (11.1) | 0 (0) | |
With any symptom 1st | 0.252 | ||
Yes | 18 (66.7) | 7 (87.5) | |
No | 9 (33.3) | 1 (12.5) | |
With any symptom 2nd | 0.029 | ||
Yes | 16 (59.3) | 8 (100) | |
No | 11 (40.7) | 0 (0) | |
With any symptom any dose | 0.058 | ||
Yes | 18 (66.7) | 8 (100) | |
No | 9 (33.3) | 0 (0) | |
Symptoms | |||
Pain | 13 (48.2) | 8 (100) | 0.009 |
Fever | 5 (18.5) | 1 (12.5) | 0.692 |
Numbness | 5 (18.5) | 1 (12.5) | 0.692 |
Headache | 4 (14.8) | 1 (12.5) | 0.869 |
Limited ROM | 1 (3.7) | 2 (25) | 0.059 |
Hesitant to take vaccine | 0.576 | ||
Yes | 22 (81.5) | 7 (87.5) | |
Maybe | 3 (11.1) | 0 (0) | |
No | 2 (7.4) | 1 (12.5) | |
Treatments | 0.234 | ||
None | 16 (59.3) | 2 (25) | |
Analgesics | 9 (33.3) | 5 (62.5) | |
Physiotherapy | 2 (7.4) | 1 (12.5) |
Appendix B
Patient | Initial MRI Date | Follow-Up MRI Date | Initial MRI Findings | Follow-Up MRI Findings | Improvements | Deteriorations |
---|---|---|---|---|---|---|
Patient 1 | 5 January 2022 | 9 July 2023 |
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Patient 2 | 25 August 2021 | 21 April 2024 |
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Patient 3 | 15 February 2021 | 30 October 2023 |
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Total n = 35 | |
---|---|
Age, mean (SD) | 53.6 (9.0) |
Age groups | |
<55 years | 19 (54.3) |
≥55 Years | 16 (45.7) |
Gender | |
Male | 16 (45.7) |
Female | 19 (54.3) |
Weight, mean (SD) | 78.5 (13.0) |
Height, mean (SD) | 166.3 (9.5) |
BMI, mean (SD) | 28.4 (4.8) |
BMI categories | |
Normal (18.5–24.9) | 7 (20) |
Overweight (25–29.9) | 15 (42.9) |
Obese (≥30) | 13 (37.1) |
Regular physical activity | |
No | 19 (54.3) |
Sometimes | 10 (28.6) |
Yes | 6 (17.1) |
Diabetes | |
No | 23 (65.7) |
Yes | 12 (34.3) |
Type of vaccine | |
Pfizer | 20 (57.1) |
Sinopharm | 7 (20) |
AstraZeneca | 7 (20) |
Others | 1 (2.9) |
Side injected | |
Left | 16 (45.7) |
Right | 16 (45.7) |
Both | 3 (8.6) |
Treatment received | |
None | 18 (51.4) |
Analgesics | 14 (40) |
Physiotherapy | 3 (8.6) |
Still have symptoms | |
Yes | 8 (22.9) |
No | 27 (77.1) |
Hesitant to take vaccines in the future | |
Yes | 29 (82.9) |
Maybe | 3 (8.6) |
No | 3 (8.6) |
First Vaccine Dose Freq. (%) | Second Vaccine Dose Freq. (%) | |
---|---|---|
Side injected | ||
Left | 18 (51.4) | 20 (57.1) |
Right | 17 (48.6) | 15 (42.9) |
Symptom | ||
Pain | 14 (40) | 18 (51.4) |
Fever | 5 (14.3) | 4 (11.4) |
Numbness | 5 (14.7) | 5 (14.3) |
Flu-like | 3 (8.8) | 1 (2.9) |
Headache | 3 (8.6) | 3 (8.6) |
Limited ROM | 2 (5.7) | 2 (5.7) |
Malaise/G Weakness | 2 (5.7) | 3 (8.6) |
Slow limb motion | 1 (2.9) | 0 |
Sweating | 1 (2.9) | 0 |
SOB | 1 (2.9) | 0 |
Dizziness | 1 (2.9) | 0 |
Heaviness | 0 | 1 (2.9) |
Start of symptoms | ||
Immediately | 7 (28.0) | 4 (16.7) |
Within 24 h | 15 (60.0) | 14 (58.3) |
Within 1 week | 3 (12.0) | 3 (12.5) |
Unknown | 10 (28.6) | 3 (12.5) |
Duration of symptoms | ||
less than 24 h | 8 (32.0) | 7 (29.2) |
1–7 days | 13 (52.0) | 10 (41.7) |
1–4 weeks | 2 (8.0) | 1 (4.2) |
More than a month | 2 (8.0) | 6 (25.0) |
Unknown | 10 (28.6) | 11 (31.4) |
Treatments | ||
None | 22 (62.9) | 20 (57.1) |
Analgesics | 12 (34.3) | 13 (37.1) |
Physiotherapy | 1 (2.9) | 2 (5.7) |
MRI Findings | Still Have Symptoms | |||
---|---|---|---|---|
Total | No | Yes | p-Value | |
Erosions | 24 (63.2) | 19 (63.3) | 5 (62.5) | 0.965 |
Bone marrow edema | 3 (7.9) | 3 (10) | 0 (0) | 0.351 |
Tendonitis | 18 (47.4) | 12 (40) | 6 (75) | 0.078 |
Supraspinatus | 15 (39.5) | 10 (33.3) | 5 (62.5) | 0.134 |
Infraspinatus | 2 (5.3) | 2 (6.7) | 0 (0) | 0.453 |
LHBT | 3 (7.9) | 2 (6.7) | 1 (12.5) | 0.587 |
Muscle edema | 4 (10.5) | 4 (13.3) | 0 (0) | 0.275 |
Adhesive capsulitis | 14 (36.8) | 12 (40) | 2 (25) | 0.435 |
Subacromial bursitis | 34 (89.5) | 27 (90) | 7 (87.5) | 0.838 |
Rotator cuff tear | 14 (36.8) | |||
Partial thickness | 9 (23.7) | 7 (23.3) | 2 (25) | 0.922 |
Full thickness | 5 (13.2) | 5 (16.7) | 0 (0) | 0.215 |
Effusion | 9 (23.7) | 7 (23.3) | 2 (25) | 0.922 |
Erosions | Tendonitis | SAB Bursitis | RC Tears | Adhesive Capsulitis | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
No | Yes | p-Value | No | Yes | p-Value | No | Yes | p-Value | No | Yes | p-Value | No | Yes | p-Value | |
Age mean (SD) | 52 (10) | 55 (8) | 0.21 | 51 (9) | 57 (7) | 0.024 | 53 (22) | 54 (6) | 0.8 | 53 (10) | 56 (6) | 0.3 | 52 (9) | 57 (7) | 0.15 |
Age groups | 0.8 | 0.8 | 0.24 | 0.4 | 0.8 | ||||||||||
<55 years | 7 (50) | 13 (54) | 11 (55) | 9 (50) | 1 (25) | 19 (56) | 14 (58) | 6 (43) | 13 (54) | 7 (50) | |||||
≥55 Years | 7 (50) | 11 (46) | 9 (45) | 9 (50) | 3 (75) | 15 (44) | 10 (42) | 8 (57) | 11 (46) | 7 (50) | |||||
Gender | 0.5 | 0.3 | 0.013 | 0.2 | 0.5 | ||||||||||
Female | 7 (50) | 15 (63) | 10 (50) | 12 (67) | 0 (0) | 22 (65) | 12 (50) | 10 (71) | 13 (54) | 9 (64) | |||||
Male | 7 (50) | 9 (38) | 10 (50) | 6 (33) | 4 (100) | 12 (35) | 12 (50) | 4 (29) | 11 (46) | 5 (36) | |||||
BMI mean (SD) | 29 (6) | 29 (4) | 0.9 | 28 (4) | 30 (5) | 0.15 | 24 (2) | 29 (5) | 0.023 | 29 (5) | 28 (3) | 0.9 | 29 (5) | 28 (3) | 0.4 |
BMI categories | 0.13 | 0.5 | 0.007 | 0.2 | 0.9 | ||||||||||
Normal (18.5–24.9) | 4 (29) | 3 (13) | 5 (25) | 2 (11) | 3 (75) | 4 (12) | 6 (25) | 1 (7) | 4 (17) | 3 (21) | |||||
Overweight (25–29.9) | 3 (21) | 13 (54) | 7 (35) | 9 (50) | 1 (25) | 15 (44) | 8 (33) | 8 (57) | 10 (42) | 6 (43) | |||||
Obese (≥30) | 7 (50) | 8 (33) | 8 (40) | 7 (39) | 0 (0) | 15 (44) | 10 (42) | 5 (36) | 10 (42) | 5 (36) | |||||
Regular physical activity | 0.9 | 0.3 | 0.8 | 0.6 | 0.4 | ||||||||||
No | 8 (57) | 12 (50) | 12 (60) | 8 (44) | 2 (50) | 18 (53) | 14 (58) | 6 (43) | 13 (54) | 7 (50) | |||||
Sometimes | 4 (29) | 8 (33) | 4 (20) | 8 (44) | 1 (25) | 11 (33) | 7 (29) | 5 (36) | 6 (25) | 6 (43) | |||||
Yes | 2 (14) | 4 (17) | 4 (20) | 2 (11) | 1 (25) | 5 (15) | 3 (13) | 3 (21) | 5 (21) | 1 (7) | |||||
Diabetes | 0.6 | 0.4 | 0.5 | 0.4 | 0.6 | ||||||||||
No | 10 (71) | 15 (63) | 12 (60) | 13 (72) | 2 (50) | 23 (68) | 17 (71) | 8 (57) | 15 (63) | 10 (71) | |||||
Yes | 4 (29) | 9 (38) | 8 (40) | 5 (28) | 2 (50) | 11 (33) | 7 (29) | 6 (43) | 9 (38) | 4 (29) | |||||
Type of vaccine | 0.6 | 0.033 | 0.3 | 0.7 | 0.029 | ||||||||||
Pfizer | 7 (54) | 14 (58) | 14 (74) | 7 (39) | 2 (50) | 19 (58) | 14 (61) | 7 (50) | 14 (61) | 7 (50) | |||||
Sinopharm | 2 (15) | 6 (25) | 4 (21) | 4 (22) | 2 (50) | 6 (18) | 5 (22) | 3 (21) | 2 (9) | 6 (43) | |||||
AstraZeneca | 4 (31) | 4 (17) | 1 (5) | 7 (39) | 0 (0) | 8 (24) | 4 (17) | 4 (27) | 7 (30) | 1 (7) | |||||
Side injected | 0.5 | 1.0 | 0.3 | 0.2 | 1.0 | ||||||||||
Left | 6 (43) | 13 (54) | 10 (50) | 9 (50) | 1 (25) | 18 (53) | 14 (58) | 5 (36) | 12 (50) | 7 (50) | |||||
Right | 8 (57) | 11 (46) | 10 (50) | 9 (50) | 3 (75) | 16 (47) | 10 (42) | 9 (64) | 12 (50) | 7 (50) | |||||
Symptoms | |||||||||||||||
Pain | 8 (57) | 14 (58) | 0.9 | 13 (65) | 9 (50) | 0.3 | 2 (50) | 20 (59) | 0.7 | 14 (58) | 8 (57) | 0.9 | 15 (63) | 7 (50) | 0.5 |
Fever | 3 (21) | 4 (17) | 0.7 | 4 (20) | 3 (17) | 0.8 | 1 (25) | 6 (18) | 0.7 | 6 (25) | 1 (7) | 0.17 | 4 (17) | 3 (21) | 0.7 |
Numbness | 1 (7) | 5 (21) | 0.3 | 4 (20) | 2 (11) | 0.5 | 0 (0) | 6 (18) | 0.4 | 2 (8) | 4 (29) | 0.1 | 3 (13) | 3 (21) | 0.5 |
Headache | 3 (21) | 4 (17) | 0.7 | 4 (20) | 3 (17) | 0.8 | 0 (0) | 7 (21) | 0.3 | 4 (17) | 3 (21) | 0.7 | 2 (8) | 5 (36) | 0.036 |
Limited ROM | 1 (7) | 2 (8) | 0.9 | 1 (5) | 2 (11) | 0.5 | 0 (0) | 3 (9) | 0.5 | 2 (8.3) | 1 (7) | 0.9 | 1 (4) | 2 (14) | 0.3 |
Still have symptoms | 0.9 | 0.08 | 0.8 | 0.4 | 0.4 | ||||||||||
Yes | 3 (21) | 5 (21) | 2 (10) | 6 (33) | 1 (25) | 7 (21) | 6 (25) | 2 (14) | 6 (25) | 2 (14) | |||||
No | 11 (79) | 19 (79) | 18 (90) | 12 (67) | 3 (75) | 27 (79) | 18 (75) | 12 (86) | 18 (75) | 12 (86) | |||||
Hesitant to take the vaccine | 0.9 | 0.7 | 0.004 | 0.13 | 0.9 | ||||||||||
Yes | 12 (86) | 20 (83) | 17 (85) | 15 (83) | 2 (50) | 30 (88) | 18 (75) | 14 (100) | 2 (8) | 1 (7) | |||||
Maybe | 1 (7) | 2 (8) | 2 (10) | 1 (6) | 0 (0) | 3 (9) | 3 (13) | 0 (0) | 2 (8) | 1 (7) | |||||
No | 1 (7) | 2 (8) | 1 (5) | 2 (11) | 2 (50) | 1 (3) | 3 (13) | 0 (0) | 2 (8) | 1 (7) | |||||
Treatments | 0.9 | 0.6 | 0.6 | 0.30 | 0.5 | ||||||||||
None | 7 (50) | 13 (54) | 9 (45) | 11 (61) | 3 (75) | 17 (50) | 11 (49) | 9 (64) | 13 (54) | 7 (50) | |||||
Analgesics | 6 (43) | 9 (38) | 9 (45) | 6 (33) | 1 (25) | 14 (41) | 10 (42) | 5 (36) | 10 (42) | 5 (36) | |||||
Physiotherapy | 1 (7) | 2 (8) | 2 (10) | 1 (6) | 0 (0) | 3 (9) | 3 (13) | 0 (0) | 1 (4) | 2 (14) |
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Obeidat, N.; Khasawneh, R.; Alrawashdeh, A.; Abdel Kareem, A.M.; Al-na’asan, M.K.; Alkhatatba, M.; Bani Essa, S. Shoulder Injury Related to Vaccine Administration (SIRVA) Following COVID-19 Vaccination: Correlating MRI Findings with Patient Demographics. Tomography 2025, 11, 53. https://doi.org/10.3390/tomography11050053
Obeidat N, Khasawneh R, Alrawashdeh A, Abdel Kareem AM, Al-na’asan MK, Alkhatatba M, Bani Essa S. Shoulder Injury Related to Vaccine Administration (SIRVA) Following COVID-19 Vaccination: Correlating MRI Findings with Patient Demographics. Tomography. 2025; 11(5):53. https://doi.org/10.3390/tomography11050053
Chicago/Turabian StyleObeidat, Naser, Ruba Khasawneh, Ahmad Alrawashdeh, Ali M. Abdel Kareem, Mohammad K. Al-na’asan, Mohammad Alkhatatba, and Suhaib Bani Essa. 2025. "Shoulder Injury Related to Vaccine Administration (SIRVA) Following COVID-19 Vaccination: Correlating MRI Findings with Patient Demographics" Tomography 11, no. 5: 53. https://doi.org/10.3390/tomography11050053
APA StyleObeidat, N., Khasawneh, R., Alrawashdeh, A., Abdel Kareem, A. M., Al-na’asan, M. K., Alkhatatba, M., & Bani Essa, S. (2025). Shoulder Injury Related to Vaccine Administration (SIRVA) Following COVID-19 Vaccination: Correlating MRI Findings with Patient Demographics. Tomography, 11(5), 53. https://doi.org/10.3390/tomography11050053