Non-radiopaque Foreign Bodies Research Articles

Serial abdominal radiographs do not significantly increase accuracy of diagnosis of gastrointestinal mechanical obstruction due to occult foreign bodies in dogs and cats.

Abdominal radiographs are commonly used in dogs and cats that present with gastrointestinal signs. When initial abdominal radiographs are equivocal for the presence or absence of gastrointestinal mechanical obstruction, follow-up abdominal radiographs may be recommended. Based on our review of the literature, no published study has been performed to evaluate the clinical utility of serial abdominal radiographs in such cases. The purpose of this study is to determine whether follow-up abdominal radiographs increase diagnostic accuracy for mechanical obstruction. A prospective cohort study was performed on client-owned dogs and cats with clinical concern for gastrointestinal mechanical obstruction and initial abdominal radiographs inconclusive for the presence of obstruction. Follow-up abdominal radiographs were performed between 7 and 28h of the initial radiographs; an abdominal ultrasound performed within 3h of the follow-up study served as the gold standard. A total of 57 patients (40 dogs and 17 cats) were recruited; 19 of 57 cases (11 dogs; 8 cats) were mechanically obstructed, all with nonradiopaque foreign bodies. Four blinded reviewers (2 radiologists, 1 radiology resident, 1 criticalist) separately assessed the initial and the combined initial/follow-up radiographic studies for diagnosis of mechanical obstruction; for each observer, there was no significant change in accuracy (P=.058-.87) for the diagnosis of mechanical obstruction. Given the lack of significant increase in diagnostic accuracy using follow-up radiographs in cases of occult gastrointestinal mechanical obstruction, other diagnostic options (eg, abdominal ultrasonography) could be considered when survey abdominal radiographs are inconclusive for the diagnosis of mechanical obstruction in dogs and cats.

Der Stachelrochenstich - eine harmlose Wellenreitverletzung?

Stingray injuries with potentially lethal outcomes have been described in the medical literature, but a stingray injury to a surfer does not belong to the injuries treated daily in Germany. We report on a stingray injury to a 31-year-old female with an uncommon course. Diagnostics of and therapy for stingray injuries are described. Stingray stings are painful injuries. In addition to the pain-relieving heat deactivation of the stingray toxin, the wound has to be cleaned to avoid secondary infection. Non-radiopaque foreign bodies should be ruled out by MRI. Stingray bites can cause severe injuries to water sportsmen and women with the need for surgical intervention.

Mo1209 Ingestion of Radiopaque and Non-Radiopaque Foreign Bodies. False Negative Matters

Mo1209 Ingestion of Radiopaque and Non-Radiopaque Foreign Bodies. False Negative Matters

Self-embedding Behavior: Radiologic Management of Self-inserted Soft-Tissue Foreign Bodies

To report on a series of self-embedding behavior (SEB), demonstrate the effectiveness and clinical effect of image-guided foreign body removal (IGFBR) in the treatment of embedded soft-tissue foreign bodies (STFBs), and evaluate the role of the radiologist in the clinical management of SEB. This retrospective study was approved by the institutional review board. From a database of 600 patients treated with IGFBR with ultrasonographic (US) and/or fluoroscopic guidance, self-injury was identified in 11 (1.8%) mainly adolescent patients with a mean age of 16 years (age range, 14-18 years). Evaluated data included number of foreign bodies; number of repeat episodes of foreign body insertion; location, type, and size of foreign body; incision size; imaging modality; and success or failure of foreign body removal. Seventy-six foreign bodies were inserted into the arm (n = 69), neck (n = 4), ankle (n = 1), foot (n = 1), or hand (n = 1) in the 11 patients. The number of STFBs per case ranged from one to 15. Foreign body types included metal (n = 40), plastic (n = 15), graphite (n = 12), glass (n = 4), wood (n = 3), crayon (n = 1), and stone (n = 1). STFB dimensions were 2.5-160.0 mm in length by 0.25-3.0 mm in thickness. Sixty-eight of the 76 STFBs were removed in the interventional radiology section. Incision lengths ranged from 4 to 8 mm (mean, 6 mm). The STFBs were removed with US guidance (n = 43), fluoroscopic guidance (n = 15), or a combination of the two modalities (n = 10). IGFBR was successful in all 68 cases, without complications. Greater awareness of SEB may result in radiologists being the first physicians to identify SEB and rapidly mobilize an interdisciplinary team for early and effective intervention and treatment. Percutaneous radiologic treatment of self-imbedded STFBs is safe, precise, and effective for radiopaque and nonradiopaque foreign bodies.

Role of HRUS in Detection and Localization of Foreign Bodies

Prick injuries with metallic and non-metallic foreign body are commonly encountered cases in surgery and orthopedics OPD. Detection and localization is difficult task with conventional radiography. Ultrasonography, CT and MRI are other modes of evaluation but CT and MRI are expensive and not easily available.About 35 patients were evaluated with USG (7.5-10 MHz Linear probe) and X-ray for clinically suspicious non-radiopaque foreign body in soft tissue and extremities. Clinical presentation, symptoms anatomical location, and foreign body retrieved after surgery were recorded. X-ray detect only 3 foreign bodies where as HRUS detected 34 patient. Most of the cases FBs were present in ankle and foot. Majority of the foreign bodies were plant thorn and wood pieces. Plain X-ray is not sensitive for detection of non-radiopaque foreign bodies but USG is sensitive and specific for detection and localization in that cases.
 TAJ 2010; 23(1): 33-37

Do we really need plain and soft-tissue radiographies to detect radiolucent foreign bodies in the ED?

Objective The objective of this study was to compare 3 imaging techniques—plain radiography, soft-tissue radiography, and ultrasonography—in detecting nonradiopaque foreign bodies in soft tissue. Methods In this randomized, blinded, and descriptive in vitro study, 40 chicken thighs with 2 types of nonradiopaque foreign bodies (wood and rubber) and 40 chicken thighs as part of a control group were evaluated to detect soft-tissue foreign bodies with plain radiography, soft-tissue radiography, and high-frequency ultrasonography. Results The overall sensitivity, specificity, as well as positive predictive and negative predictive values of plain radiography for both nonradiopaque foreign bodies were 5%, 90%, 33%, and 48%, respectively; those of soft-tissue radiography for both nonradiopaque foreign bodies were 5%, 90%, 33%, and 48%, respectively; and those of ultrasonography for both nonradiopaque foreign bodies were 90%, 80%, 81%, and 89%, respectively. Conclusions In this experimental model, the results show that high-frequency ultrasonography is superior to plain and soft-tissue radiographies and that the latter 2 techniques are similarly poor at detecting nonradiopaque foreign bodies.

Ultrasound Assisted Detection and Removal of Wooden Foreign Bodies in Soft Tissue

Soft tissue foreign bodies represent a common cause for emergency department visits. Diagnosis may be difficult especially with non-radiopaque foreign bodies. Undetected wooden foreign bodies can cause significant morbidity, repeat visits, high cost, and extensive surgery. We report a case in which ultrasound was used in the Emergency Department to detect and remove wooden foreign bodies from the soft tissue. Ultrasound and other imaging modalities that may aid in the early diagnosis are discussed.

Diagnostic ultrasound as an essential screening procedure in detection and evaluation of non-radiopaque foreign bodies in the musculoskeletal system and importance of power Doppler

Diagnostic ultrasound as an essential screening procedure in detection and evaluation of non-radiopaque foreign bodies in the musculoskeletal system and importance of power Doppler

Imaging of chronically draining sinuses in the musculoskeletal system by “ultrasonosinography”: a useful diagnostic procedure

Objective: The objective was to study the efficiency of ultrasonography of chronically draining sinuses in the musculoskeletal system.Methods: 30 patients with chronically draining sinuses in the musculoskeletal system underwent plain radiographs of the affected part and sonography of the affected and contralateral normal part with a 7 to 12 MHz-linear phased array transducer using Toshiba Power Vision 6000 equipment and contrast sinography using Ultravist (iopramide).Results: Plain radiographs were useful in illustrating: 1) radiopaque foreign bodies in 2 cases, but 10 nonradiopaque foreign bodies were missed; and 2) bony changes of ostemyelitis in 12 patients. Ultrasound showed: 1) all 12 foreign bodies (nonradiopaque and radiopaque) with exact localization, depth, and size; 2) complete sinus tract in 30 patients along with alternate channels; 3) soft tissue abscesses in 6 patients; and 4) evidence of osteomyelitis and subperiosteal abscesses with precise extent in 12 patients. Contrast sinography delineated complete sinus tract in 25 patients, but in 5 patients, complete sinus tract could not be outlined, possibly because of obstruction to contrast due to debris and alternate channels. All foreign bodies were missed as they were masked by the contrast material. The extent of soft tissue abscesses could not be exactly evaluated.Conclusions: Ultrasound is useful in giving all details of chronically draining sinuses in the musculoskeletal system along with all the causes. Ultrasound imaging of chronically draining sinuses in the musculoskeletal system may be termed as “ultrasonosinography.” Objective: The objective was to study the efficiency of ultrasonography of chronically draining sinuses in the musculoskeletal system. Methods: 30 patients with chronically draining sinuses in the musculoskeletal system underwent plain radiographs of the affected part and sonography of the affected and contralateral normal part with a 7 to 12 MHz-linear phased array transducer using Toshiba Power Vision 6000 equipment and contrast sinography using Ultravist (iopramide). Results: Plain radiographs were useful in illustrating: 1) radiopaque foreign bodies in 2 cases, but 10 nonradiopaque foreign bodies were missed; and 2) bony changes of ostemyelitis in 12 patients. Ultrasound showed: 1) all 12 foreign bodies (nonradiopaque and radiopaque) with exact localization, depth, and size; 2) complete sinus tract in 30 patients along with alternate channels; 3) soft tissue abscesses in 6 patients; and 4) evidence of osteomyelitis and subperiosteal abscesses with precise extent in 12 patients. Contrast sinography delineated complete sinus tract in 25 patients, but in 5 patients, complete sinus tract could not be outlined, possibly because of obstruction to contrast due to debris and alternate channels. All foreign bodies were missed as they were masked by the contrast material. The extent of soft tissue abscesses could not be exactly evaluated. Conclusions: Ultrasound is useful in giving all details of chronically draining sinuses in the musculoskeletal system along with all the causes. Ultrasound imaging of chronically draining sinuses in the musculoskeletal system may be termed as “ultrasonosinography.”

A retained wooden foreign body in the foot detected by ultrasonography. A case report.

An orthopaedic surgeon is often called on to remove a foreign body in an extremity. When the foreign body is radiopaque, usually it can be localized on standard radiographs or by fluroscopy. When the foreign body is not radiopaque, such as a wooden splinter or a thorn, it may remain undetected even after exploration. High-resolution, real-time ultrasonography has proved to be both sensitive and specific when used to detect non-radiopaque foreign bodies and has helped greatly to find and remove them.

Radiographic Imaging of Foreign Bodies in the Hand

Injuries involving foreign bodies in the hand are common. Index of suspicion should be high in any hand injury, particularly with a proper history. Plain radiographs should be obtained liberally and multiple views always taken. Xeroradiography, if available, is helpful if the plain radiographs are normal and a foreign body is suspected. Ultrasound is useful particularly in the detection of non-radiopaque foreign bodies and can provide guidance for removal of foreign objects if they are not readily found at surgery. Computed tomography (CT) and magnetic resonance imaging (MRI) may be used in rare instances if other studies have failed to detect a suspected foreign object, particularly a small wood or wood-like fragment. CT and MRI are the best studies to evaluate complications of retained foreign bodies.

The role of ultrasound in the detection of non-radiopaque foreign bodies

Fifty consecutive ultrasound examinations performed for suspected non-radiopaque foreign bodies in extremities were reviewed to establish the value of this procedure. Ultrasound detected 21 of 22 foreign bodies found at operation. There were three false positive examinations. The sensitivity was 95.4%, the specificity 89.2%, the positive predictive value 87.5% and the negative predictive value was 96.2%. This study demonstrates that ultrasound is a reliable method for detecting non-radiopaque foreign bodies and makes a significant contribution to patient management.

A Clinical Study on 63 Cases with Foreign Bodies of the Tracheo-bronchial Tree

A review was made on 63 cases (males: females=43:20) with various kinds of foreign bodies of the tracheobronchial tree treated mainly at the ENT Department of Hirosaki University and at the Central Hospital of Aomori Prefecture. The youngest among the 63 cases was 6 month-old baby boy and the eldest was 63 year-old male. Bronchoscopic removal of foreign bodies was carried out without general anesthesia on 21 cases who were seen before 1967, whereas since 1968, ventilation bronchoscopy under general anesthesia has been in use when necessary. Postbronchoscopic tracheostomy was necessitated in only 1 case.The 63 foreign bodies were classified into two categories, i. e. non-radiopaque and radiopaque, and the ratio was 45:18. Among the non-radiopaque foreign bodies, there were peanuts (24 cases), beans, seeds, corns or other vegetables (9 cases), pieces of meat (3 cases), plastic pencil cap (4 cases), plastic bullet of toy gun (2 cases), a part of plastic toy (2 cases) and celluloid pipe (1 case). Sixteen among the 24 cases with peanuts were under 2 years of age (males: females=11:5). The radiopaque foreign bodies were: needles (2 cases), drawing pin (2 cases), nail, single false tooth, head of ball-point pen, staple, screw of compass and dental reamer (1 case each). Among those, 2 staples located in the lingular division and a pin located in the right upper anterior bronchus (B3α) were removed under X-ray TV monitoring.

Detection of aspirated foreign bodies with xeroradiography.

Xeroradiography offers some advantages over conventional radiography in the demonstration of nonradiopaque foreign bodies. High-kV anteroposterior xerotomography gives the clearest, most readily interpreted display of the foreign body and the tracheobronchial tree. Lateral and oblique plain xeroradiographs are likely to be most useful in young children in whom respiration cannot be suspended.