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Case Reports
. 2022 Jan;302(1):84-87.
doi: 10.1148/radiol.2021211374. Epub 2021 Aug 17.

Parsonage-Turner Syndrome Following COVID-19 Vaccination: MR Neurography

Sophie C Queler  1 , Alexander J Towbin  1 , Carlo Milani  1 , Jeremy Whang  1 , Darryl B Sneag  1
Affiliations
Case Reports

Parsonage-Turner Syndrome Following COVID-19 Vaccination: MR Neurography

Sophie C Queler et al. Radiology. 2022 Jan.

Abstract

Vaccination is one of the several known triggers of Parsonage-Turner syndrome (PTS). This case series describes two individuals with clinical presentations of PTS whose symptoms began 13 hours and 18 days following receipt of the Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273 COVID-19 vaccine, respectively. The diagnosis of PTS was confirmed by using both electrodiagnostic testing and 3.0-T MR neurography. Although research is needed to understand the association between PTS and COVID-19 vaccination, MR neurography may be used to help confirm suspected cases of PTS as COVID-19 vaccines continue to be distributed worldwide.

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Conflict of interest statement

Disclosures of conflicts of interest: S.C.Q. No relevant relationships. A.J.T. Grants from Cystic Fibrosis Foundation and Guerbet; royalties or licenses from Elsevier; consulting fees from Applied Radiology; support for attending meetings and/or travel from Society for Imaging Informatics in Medicine and Children's Oncology Group; board of directors membership in Society for Imaging Informatics in Medicine and Society for Pediatric Radiology. C.M. No relevant relationships. J.W. No relevant rela-tionships. D.B.S. Hospital for Special Surgery has an institutional research agreement with GE Healthcare.

Figures

None
Graphical abstract
Patient 1: A 49-year-old man with Parsonage-Turner syndrome that developed 13 hours following the first dose of the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine. (A) Axial T2-weighted fast-spin echo fat-suppressed image 8 weeks after symptom onset demonstrates denervation edema pattern of the pronator teres (PT) and flexor carpi radialis (FCR) muscles. (B) Axial T2-weighted gradient-echo image demonstrates abnormal signal hyperintensity of the PT/FCR, anteromedially positioned, fascicular bundle (arrow, magnified inset) of the median nerve (oval) within the distal arm. (C) Oblique sagittal curved multiplanar reformatted T2-weighted gradient-echo image demonstrates multiple severe intrinsic constrictions (arrows) of the PT/FCR bundle of the median nerve (bracket).
Figure 1:
Patient 1: A 49-year-old man with Parsonage-Turner syndrome that developed 13 hours following the first dose of the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine. (A) Axial T2-weighted fast-spin echo fat-suppressed image 8 weeks after symptom onset demonstrates denervation edema pattern of the pronator teres (PT) and flexor carpi radialis (FCR) muscles. (B) Axial T2-weighted gradient-echo image demonstrates abnormal signal hyperintensity of the PT/FCR, anteromedially positioned, fascicular bundle (arrow, magnified inset) of the median nerve (oval) within the distal arm. (C) Oblique sagittal curved multiplanar reformatted T2-weighted gradient-echo image demonstrates multiple severe intrinsic constrictions (arrows) of the PT/FCR bundle of the median nerve (bracket).
Patient 2: A 44-year-old man with Parsonage-Turner syndrome that developed 18 days following the second dose of the Moderna (mRNA-1273) COVID-19 vaccine. (A) Coronal T2-weighted fat-suppressed fast-spin echo (FSE) image 5 weeks after symptom onset demonstrates denervation edema pattern of the supraspinatus (black star) and infraspinatus (white star) muscles. (B) Oblique axial curved multiplanar reformatted T2-weighted fat suppressed FSE image demonstrates four severe intrinsic constrictions (arrows) of the suprascapular nerve.
Figure 2:
Patient 2: A 44-year-old man with Parsonage-Turner syndrome that developed 18 days following the second dose of the Moderna (mRNA-1273) COVID-19 vaccine. (A) Coronal T2-weighted fat-suppressed fast-spin echo (FSE) image 5 weeks after symptom onset demonstrates denervation edema pattern of the supraspinatus (black star) and infraspinatus (white star) muscles. (B) Oblique axial curved multiplanar reformatted T2-weighted fat suppressed FSE image demonstrates four severe intrinsic constrictions (arrows) of the suprascapular nerve.
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