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Age: 13

Sex: Female

Indication: Concern for foreign body

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Case #24


Findings

  • Linear echogenic foreign body in the plantar aspect of the index finger measuring 10 mm in length and 1 mm in width, with the superficial aspect located 2 mm deep to the skin surface
  • Surrounding soft tissue edema and hyperemia


Diagnosis

Soft tissue foreign body (wood splinter)

Sample Report

Linear echogenic foreign body in the plantar aspect of the index finger measuring 10 mm in length and 1 mm in width, with the superficial aspect located 2 mm deep to the skin surface.

Surrounding soft tissue edema and hyperemia, which may be reactive or related to cellulitis.


Discussion

  • Know what types of materials are radiopaque vs radiolucent:
    • Radiopaque: glass, most metals (not aluminum), animal bones
    • Radiolucent: wood, most foods, plastic, aluminum
  • Radiolucent materials are often invisible on radiographs and can sometimes be difficult to identify on CT (especially wood, which can be mistaken for subcutaneous gas)
  • Foreign bodies are almost always echogenic on ultrasound, making ultrasound a good diagnostic test, particularly for superficial foreign bodies
  • Foreign bodies also commonly have a hypoechoic rim (surrounding inflammatory response) on ultrasound, particularly after in place a day or more, which further improves visualization



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