Catherine H. Chung
A 15-year-old teenager presents with pain in her right buttock after sliding down a wooden plank earlier at school. She feels like there might be something in her skin, and her exam is noted to have some focal tenderness along her right buttock but no fluctuance or induration. X-rays are negative for foreign body.
You perform a bedside ultrasound exam over the affected area. What do you observe?
Bedside ultrasound reveals a foreign body in the skin as noted by the hyperechoic linear image with shadowing below it.
Non-metallic foreign bodies will often not show up on plain x-rays. Bedside ultrasound not only confirms diagnosis but allows visualization of the orientation of the foreign body and depth to help aid in its removal. This patient ended up having a 6 cm wooden splinter.
Keywords: foreign body, ultrasound, pitfalls
Noble V. Ultrasound for procedure guidance. In Manual of Emergency and Critical Care Ultrasound. Cambridge: Cambridge University Press, 2007: 224–