Abstract Body

BACKGROUND: Intramuscular injections are a useful technique but not without risks, especially if they are applied by a person without proper training.

CASE: 50 years-old man consults for 24 hours back pain, right sciatica, pharestesies and stumble when walking. History of glaucoma and corticosteroid intolerance. Denies taking drugs. He doesn’t identify triggers. Physical exploration: sacrum pain, preserved spinal mobility. Positive Lassegue maneuver, decreased cutaneous sensation in the distal third of the leg, paresia 2/5 in foot mobility with gait disorder. No fever. No skin injuries.

Referred to traumatology service. Hospitalized for study with diagnosis of nonspecific neurological deficit. In there, he acknowledges self-administration of anabolic injections for 6 weeks, 3 times/week. Last injection coincides with the start of the clinic.

Lumbar tomography: no signs of acute pathology or root involvement.

Pelvic tomography: cellulitis of the subcutaneous tissue, involvement of perimuscular fat of gluteus maximus, both gemellus, quadratus femoris, biceps femoris, semitendinosus and adductor magnus muscles, signs of myositis without collections. Impairment of fat surrounding the right sciatic nerve, without being able to discard nerve injury at this level.

Blood analysis: leukocytes 11.89*10⁹/L, neutrophils 8.92*10^12/L, globular sedimetation rate 13mm

Treatment with dexketoprofen with good evolution, achieving the normalization of analytical parameters and sensory and motor improvement.

CONCLUSIONS: Patients are often unaware of the dangers of self-medication, both because of the drug itself and the method they use. Sciatic nerve injury is one of the most common complication of intramuscular injections and can take weeks to resolve or even may never resolve.