Detection of Foreign Bodies using Ultrasound: A Possible Pitfall

Abstract

Recently, a number of reports have brought the use of ultrasound scanning in the detection of foreign bodies to the field of hand surgery. A case is presented in which ultrasound was not able to diagnose the presence of a large (3.5 × 0.5 × 0.5 cm) nonradiopaque wooden foreign body lying between the flexor tendons of the forearm. However, embedded in ultrasound gel, the piece could readily be identified. This report serves as a reminder that the anatomical localization of a foreign body amid structures with vastly different echogenicity from its surroundings (such as flexor tendons of the hand and forearm) may reduce the usefulness of diagnostic ultrasound and that in such circumstances clinical suspicion may be a more reliable indication for exploratory surgery.