Case report and brief review of literature on sonographic detection of accidentally implanted wooden foreign body causing persistent sinus

Bhaskar Borgohain,Akash Handique,Parag Jyoti Gogoi,Nitu Borgohain

doi:10.1186/2036-7902-4-10

Abstract

Despite advances in imaging techniques, the detection of vegetative foreign bodies in soft tissues remains a difficult and sometimes even a challenging task. Clinical evaluation of such patient may present several months or even years after the initial injury and clinician may fail to elicit an antecedent skin puncture. X-ray examination will miss radiolucent foreign bodies. A 15-year-old boy presented with a draining non-healing sinus at the lateral aspect of his right thigh for 9 months. Musculoskeletal ultrasonography was ordered after ruling out chronic osteomyelitis to detect possible lesions around the thigh. High-frequency linear ultrasonic probe readily detected an elongated foreign body within the vastus lateralis muscle. A long piece of wood was confirmed at surgery. Non-healing sinus with normal finding in radiograph following old trauma should raise the suspicion of implanted radiolucent foreign body/bodies. The role of diagnostic ultrasound as a valuable screening tool for the detection of foreign body is briefly reviewed.

Highlights

Despite advances in imaging techniques, the detection of retained vegetative foreign bodies remains a difficult and challenging task and may require the use of imaging modalities for better localization
Patients may present for evaluation several months or even years after the initial injury, and clinical evaluation may fail to elicit a history of antecedent skin puncture
While most of the metal and glass foreign bodies can be detected by plain radiography, organic substances such as wood and vegetative materials are radiolucent, and these radiolucent foreign bodies are usually more prone to cause an inflammatory reaction and infection [4]

Summary

Introduction

Despite advances in imaging techniques, the detection of retained vegetative foreign bodies remains a difficult and challenging task and may require the use of imaging modalities for better localization. Patients may present for evaluation several months or even years after the initial injury, and clinical evaluation may fail to elicit a history of antecedent skin puncture. When a history of penetrating trauma is suggested, its severity is difficult to estimate clinically [1]. Radiographs may fail to reveal the retained radiolucent foreign bodies leading to missing the diagnosis entirely [1]. The margins of weight, cough, or chest pain. After 9 months from the day of injury, he visited our hospital

Findings

Discussion

Conclusion