Hematoma after Intramuscular Diclofenac Injection Mimic Sciatica Pain in Lumbar Radiculopathy: A Case Report
Keywords:
Sciatica, Sciatic nerve injection injury, Nerve injury, Diclofenac injectionAbstract
Introduction Nerve injection injuries are common and the most common injured nerve is sciatic
nerve. This report was demonstrated a patient who has problem after diclofenac intramuscular
injection.
Report A 50-year-old male with lumbar radiculopathy. He was treated with diclofenac injection.
Three weeks later, he came back again with severe sciatica pain. He was diagnosed with a mass
irritated sciatic nerve. He underwent an immediate exploration and open debridement. The
intraoperative finding was 100 ml of blood located beneat of gluteal medius area. No pus or
infected material were observed. His sciatica pain was disappeared after surgery. The specimens
culture were negative after 3 days of incubation.
Discusssion Intramuscular diclofenac injection frequently produces pain after injection. There
are several reports the sciatic nerve injection injury (SNII) but they focused only direct trauma
and drug associated with SNII. This is a first report of a hematoma mimic sciatica besides the
direct nerve trauma or agent related with SNII.
Conclusion Pain after diclofenac injection may cause by direct sciatic injury or hematoma
formation from small vessel injury. The location of injection is important and it will be safer
with longer compression.
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