Body Art Causing Radiological Artifact: A Case Study

Abstract

An otherwise healthy 26-year-old pregnant woman in active labor requested epidural analgesia for pain relief. Her history was significant for scoliosis, having undergone surgical correction with Harrington rods in the thoracic spine 10 years earlier. A well-healed midline surgical scar was apparent between her scapulae. The lumbar area of the back was free of any obvious surgical scars. She offered spine radiographs, taken 5 years earlier, to confirm location of surgical hardware. Examination of the radiographs (Figure 1) did indeed confirm thoracic spinal hardware, but also raised concern for possible lumbar spinal instrumentation, which could potentially complicate the epidural anesthetic. On further questioning, a piece of dangling navel jewelry, also known as a ‘‘belly button’’ ring, was the cause for this radiological artifact. Epidural analgesia for her labor proceeded without difficulty. The practice of body piercing and tattooing goes back to ancient civilizations. Historically, body art was often considered deviant or rebellious behavior, relegated to a nonmainstream segment of the population. However, recent data indicate that this practice has spread throughout all socioeconomic classes and age groups (Laumann & Derick, 2006; Stirn, 2003). The popularity of body art has increased in prevalence over recent years with some data suggesting 25% to50%of the population with some form of body art, either piercings (other than