Abstract
Although porcupine quill injuries are common in dogs, the detailed appearance of the quill on diagnostic ultrasound, computed tomography, and magnetic resonance imaging has not been sufficiently described. A 4-year-old, intact, female Jack Russel terrier presented with severe neck pain and ataxia after an altercation with a porcupine 2 weeks earlier. Radiology, diagnostic ultrasound, computed tomography and magnetic resonance imaging were all utilised to identify a quill imbedded in the cervical vertebral canal and cervical musculature and were compared to each other. Surgical removal of the quill, guided by imaging findings, led to the resolution of the clinical signs in the patient. Previous ultrasound imaging reports have just stated that the quill consists of paralell hyperechoic lines, and do not mention the finer hyperechoic lines inbetween and do not try to provide a reason for the appearance. Previous computed tomography (CT) reports just mention identifying the quill on CT images (whether or not CT could identify the fragments), but do not go into detail about the attenuating appearance of the quill nor try to relate this to the composition of the quill. This is to the authors’ knowledge the first report with detailed imaging descriptions of a case of cranial cervical vertebral canal porcupine quill foreign body in a dog. This is also the first report to allude to a possible difference in imaging findings related to quill structure because of keratin orientation and melanin content. The ideal imaging modality to use remains elusive, but ultrasound, computed tomography and magnetic resonance imaging could all identify the quill.
Highlights
Porcupine quills, as well as wooden splinters, are common foreign bodies found in the canine head, especially the face, in North America (Grahn et al 1995; Yanofsky, Bonneau & Breton 1986)
But migration into the central nervous system is rare (Daoust 1991; Johnson et al 2006; Schneider, Chen & Tucker 2010). Both septic and sterile foreign body reactions can result from penetrating porcupine quills, due primarily to their being sharp, barbed (North American or Erethizon spp.) or ridged or scaled (African or Hystrix spp.), which aids migration as well as being an irritant, and their often contaminated nature (Grahn et al 1995; Sauvé, Sereda & Sereda 2012; Vincent & Owers 1986)
Few have described the quill itself in much detail. This is the first report, to the authors’ knowledge, comparing all of the diagnostic imaging modality findings in a case of cranial cervical spinal cord penetration via the pharynx by a porcupine quill in a dog. This is the first report to allude to a possible difference in imaging findings related to quill structure
Summary
As well as wooden splinters, are common foreign bodies found in the canine head, especially the face, in North America (Grahn et al 1995; Yanofsky, Bonneau & Breton 1986). Adjacent to the cranial tip of the quill, and somewhat obscuring it, was poorly defined hyperattenuating focus (HU 60–90) that demonstrated moderate heterogeneous contrast enhancement (125 HU) within the right ventro-lateral spinal cord as well as the area adjacent to the cord, suspected to be because of neovascularisation and corresponding to the area of granulation tissue and haemorrhage suspected on MRI (Figure 3b and c). A second, shorter fragment, 25 mm long, was identified entering the spinal canal at the level of the C1–C2 inter-arcuate space and was surgically removed after a partial dorsal laminectomy was performed (Figure 4) This fragment did not penetrate the cord and the two http://www.jsava.co.za.
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