Presentation
Left foot drop and inability to walk after IM injection to the left gluteal region.
Patient Data
Thickened striated portion of the left sciatic nerve having altered signal intensity posterior to the left ischial spine and between the left gluteus maximus and gluteus medius muscles, measuring about 4.5 cm in length, with evidence of mixed T2 hypo/hyperintense and T1 iso/hyperintense signals, suggestive of oedema and blood content within the nerve.
There is diffuse thickening and oedema of the sciatic nerve distal to this segment involving the whole visualised segment, which appears homogenously STIR hyperintense.
Oedematous changes in the left gluteus maximus muscle are noted.
Features are consistent with left sciatic nerve injury, with blood content within it and diffuse oedema distal to the injured segment.
Minimal left hip joint effusion is noted.
Case Discussion
Post-injection sciatic nerve injury is a rare complication in children, and it is usually secondary to intramuscular injection.
The best site of intramuscular injection in infants and young children is the middle of the outer thigh, to avoid this complication.
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