Soft Tissue Foreign Bodies
Ultrasonography presents several advantages over traditional imaging techniques for the identification and localization of foreign bodies - Ellsworth Wright MD
image by: Amal Graafstra
HWN Suggests
BrownSound: Foreign Bodies
Radiopaque objects such as metal will likely appear on plain films, however objects made of wood or other organic material are radiolucent.
The user will want to start with the high-frequency (7.5-MHz or higher) linear array transducer that is usually used for soft tissue ultrasound. Apply gel and gently place the probe perpendicular to the skin where the patient is complaining of a foreign body sensation or pain. Alternatively, if there is significant discomfort with direct probe contact, the user can submerge the body part in a water bath, which serves as an excellent conduction medium for sound waves, and no direct contact with the tender skin is required.
Resources
POCUS
Bedside ultrasound can help evaluate for and identify foreign bodies that are not radiopaque such as plastic, organic material, and wood.
Foreign Body Imaging
Imaging modalities available for detecting foreign bodies include plain film radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound. Each modality has its strengths and weaknesses that vary depending on the composition material of the foreign body, as well as the object’s location.
Foreign Body Localization
Any patient presenting with a wound should always raise concern for a possible retained foreign body.
Soft Tissue Foreign Bodies
Soft tissue injuries are a common presentation. While retained foreign bodies are not that common, missed ones are a common cause of malpractice claims.
Soft Tissue Foreign Bodies: ED Presentation, Evaluation, and Management
Maintain a high suspicion for foreign body in evaluation of all wounds.
Soft Tissue Foreign Body
Wounds deeper than 5 mm and wounds whose depth cannot be visualized have a higher association with foreign bodies.
Soft Tissue – A PoCUS-Guided Approach
Probe selection: the use of a high-frequency ultrasound probe is recommended. This allows for greater axial resolution at the expense of less penetration, which is suitable for the detection of small foreign bodies, as they typically lodge in superficial tissues.
The Foreign Body
Given the size of the scratch on his leg and the fact that this was caused by something from his garden, we needed to consider the possibility of a retained foreign body. You would expect that if there was retained foreign material, it might be wood and would not show up on X-ray. A bedside soft tissue ultrasound in two planes was performed...
Trick of the Trade: "Punch out" the foreign body
For non-cosmetically important and neurovascularly low-risk areas where there is a high suspicion for a small retained foreign body, you can use a small punch biopsy tool (1-2 mm diameter) directly over the maximally tender point to remove the foreign body.
Wine Glass in the Foot: A Case Study
Do not remove the object until baseline imaging has been obtained if bone, joint, or other injury is suspected. Secure object with tape, braces, or splints if needed to avoid unnecessary movement of the object, which can cause pain or excessive bleeding.
BrownSound: Foreign Bodies
The user will want to start with the high-frequency (7.5-MHz or higher) linear array transducer that is usually used for soft tissue ultrasound. Apply gel and gently place the probe perpendicular to the skin where the patient is complaining of a foreign body sensation or pain.
Introducing Stitches!
Your Path to Meaningful Connections in the World of Health and Medicine
Connect, Collaborate, and Engage!
Coming Soon - Stitches, the innovative chat app from the creators of HWN. Join meaningful conversations on health and medical topics. Share text, images, and videos seamlessly. Connect directly within HWN's topic pages and articles.
