Presentation
History of thorn prick one month back while working in the field. Pain and swelling in medial left foot since then.
Patient Data
No radio-opaque foreign body is evident on the left foot radiographs.
Ultrasound of the left foot shows linear echogenic structure in the muscular plane, consistent with thorn. Small hypoechoic collection is noted around the thorn.
There is STIR hypointense tubular structure in the abductor hallucis muscle measuring 1.5 cms in length and 2.1mm in width – consistent with foreign body. The foreign body is not evident on T1 image.
There is small STIR hyperintense fluid collection around the foreign body measuring 1.0 x 0.5 x 0.6 cms (AP x TR x CC). There is also edema of abductor hallucis muscle.
Mild ankle and posterior subtalar joint effusions are noted. No synovial thickening.
Obliquely oriented tubular signal void is seen in medial foot - consistent with foreign body.
Case Discussion
Foreign bodies in the foot are common in people who work on barefoot in India. The frequent foreign bodies include thorn, wooden splinter, nail or glass pieces. Radiographs can detect metallic foreign bodies. High resolution ultrasound can localize the radiolucent foreign body and can detect associated complications.
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