{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:29:53Z","timestamp":1786739393523,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Palpable thigh nodularity is a relatively frequent indication for imaging of vaccination-age children, with patients often referred by their community physician or general practitioner. Ultrasound (US) is the imaging modality of choice to delineate the abnormality, and we present a number of characteristic findings that permit the radiologist and pediatrician to accurately identify the cause. A retrospective review was performed at the largest children's hospital in a European country between 2015 and 2017 over a 30-month period. A search was performed of the hospital's Picture Archiving and Communication System (PACS) for all children referred for a soft-tissue, upper limb, or lower limb US between January 2015 and July 2017. The findings were collated and stored in a spreadsheet. Nine patients were identified who developed subcutaneous nodules in the thigh at some point during their childhood vaccination schedule. Three of these patients had clinical histories strongly suggestive of a diagnosis of abscess or foreign body. The remaining six patients were selected for more in-depth analysis. Four of these patients had US features consistent with vaccination granuloma. Two patients were ultimately diagnosed with venolymphatic malformations. Palpable thigh nodularity in a child of vaccination age is encountered with a reasonable frequency. When encountered, granulomas tend to be located within the subcutaneous tissues, and we postulate that this is due to erroneous administration of a vaccine into the subcutis rather than into the muscle.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmu.jmu_51_20","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T08:28:10Z","timestamp":1626337690000},"page":"129-131","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["The Evaluation of Palpable Thigh Nodularity in Vaccination-age Children \u2013 Differentiating Vaccination Granulomas from Other Causes"],"prefix":"10.4103","volume":"29","author":[{"given":"Douglas","family":"Mulholland","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eimear A.","family":"Joyce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Foran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisling","family":"Snow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-13-20240830","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1007\/s00431-014-2318-2","article-title":"How common are long-lasting, intensely itching vaccination granulomas and contact allergy to aluminium induced by currently used pediatric vaccines? A prospective cohort study","volume":"173","author":"Bergfors","year":"2014","journal-title":"Eur J Pediatr"},{"key":"R2-13-20240830","doi-asserted-by":"crossref","first-page":"W92","DOI":"10.2214\/AJR.13.11743","article-title":"Multimodality imaging of foreign bodies of the musculoskeletal system","volume":"203","author":"Jarraya","year":"2014","journal-title":"AJR Am J Roentgenol"},{"key":"R3-13-20240830","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1111\/pde.13953","article-title":"Sonographic features of vaccination granulomas in children with delayed-type hypersensitivity to aluminum","volume":"36","author":"Sechi","year":"2019","journal-title":"Pediatr Dermatol"},{"key":"R4-13-20240830","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s00431-005-1704-1","article-title":"Nineteen cases of persistent pruritic nodules and contact allergy to aluminium after injection of commonly used aluminium-adsorbed vaccines","volume":"164","author":"Bergfors","year":"2005","journal-title":"Eur J Pediatr"},{"key":"R5-13-20240830","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1542\/peds.2014-1690","article-title":"Case report of subcutaneous nodules and sterile abscesses due to delayed type hypersensitivity to aluminum-containing vaccines","volume":"138","author":"Lauren","year":"2016","journal-title":"Pediatrics"},{"key":"R6-13-20240830","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0264-410X(03)00531-0","article-title":"Unexpectedly high incidence of persistent itching nodules and delayed hypersensitivity to aluminium in children after the use of adsorbed vaccines from a single manufacturer","volume":"22","author":"Bergfors","year":"2003","journal-title":"Vaccine"},{"key":"R7-13-20240830","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4161\/hv.4.1.4747","article-title":"Evidence based route of administration of vaccines","volume":"4","author":"Cook","year":"2008","journal-title":"Hum Vaccin"},{"key":"R8-13-20240830","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1136\/bmj.321.7271.1237","article-title":"The importance of injecting vaccines into muscle. Different patients need different needle sizes","volume":"321","author":"Zuckerman","year":"2000","journal-title":"BMJ"},{"key":"R9-13-20240830","doi-asserted-by":"crossref","first-page":"479","DOI":"10.5811\/westjem.2016.12.32279","article-title":"Skin to intramuscular compartment thigh measurement by ultrasound in pediatric population","volume":"18","author":"Duong","year":"2017","journal-title":"West J Emerg Med"},{"key":"R10-13-20240830","first-page":"257","article-title":"Physiology of granulomas","volume":"49","author":"Soler","year":"1993","journal-title":"Rev Pneumol Clin"},{"key":"R11-13-20240830","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/j.1365-2559.2005.02312.x","article-title":"Persistent nodules at injection sites (aluminium granuloma)-Clinicopathological study of 14 cases with a diverse range of histological reaction patterns","volume":"48","author":"Chong","year":"2006","journal-title":"Histopathology"},{"key":"R12-13-20240830","doi-asserted-by":"crossref","first-page":"137","DOI":"10.4103\/0974-2077.74487","article-title":"Lymphatic malformations: Current status","volume":"3","author":"Khunger","year":"2010","journal-title":"J Cutan Aesthet Surg"},{"key":"R13-13-20240830","first-page":"384","article-title":"The effect of soft-tissue ultrasound on the management of cellulitis in the emergency department","volume":"13","author":"Tayal","year":"2006","journal-title":"Acad Emerg Med"},{"key":"R14-13-20240830","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1055\/s-0041-1734408","article-title":"Accuracy of ultrasonography in detecting radiolucent soft-tissue foreign bodies","volume":"24","author":"Tahmasebi","year":"2014","journal-title":"Indian J Radiol Imaging"},{"key":"R15-13-20240830","doi-asserted-by":"crossref","first-page":"217","DOI":"10.14366\/usg.14068","article-title":"Ultrasonography of soft tissue \u201coops lesions\u201d","volume":"34","author":"Chung","year":"2015","journal-title":"Ultrasonography"}],"container-title":["Journal of Medical Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/JMU.JMU_51_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:28:37Z","timestamp":1786735717000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/JMU.JMU_51_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/jmu.jmu_51_20","relation":{},"ISSN":["0929-6441"],"issn-type":[{"value":"0929-6441","type":"print"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}