Embolia cutis medicamentosa (Nicolau Syndrom) is a very rare complication o
f intramuscular injections which presents with extensive necrosis of the in
jected skin area. Intra-arterial and/or para-arterial injections after prio
r perforation of certain vessels are discussed as possible pathogenetic mec
hanisms. We describe the occurrence of embolia cutis medicamentosa after in
tra-articular injections into the knee.