Localization and guided removal of soft-tissue foreign bodies with sonography.

Shiels, William E.; Babcock, Diane S.; Wilson, J. S. G.; Burch, R A

doi:10.2214/ajr.155.6.2122680

Cited by 174 publications

(99 citation statements)

References 2 publications

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“…5,7,8 Sonography is well established as an accurate method for diagnosing clinically suspected foreign bodies, and realtime sonographic visualization can guide surgical removal. [1][2][3][4]9 When the clinical history and sonographic findings are positive for a foreign body, no further imaging workup is needed. We emphasize the value of sonography in the diagnosis of clinically unsuspected foreign bodies and have shown the relative ineffectiveness of more elaborate and expensive imaging examinations.…”

Section: Discussionmentioning

confidence: 99%

Clinically Unsuspected Foreign Bodies

Soudack

Nachtigal

Gaitini

2003

Journal of Ultrasound in Medicine

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Objective. To show the value of sonography in the detection of clinically unsuspected foreign bodies appearing as soft tissue masses. Methods. High-resolution B-mode and color Doppler sonography was performed in 288 patients referred with superficial soft tissue masses over a period of 2 years. Results. In 8 lesions in 6 patients, sonography showed small curved or linear echogenic structures surrounded by hypoechoic masses characteristic of foreign bodies with granulation tissue. One lesion had increased vascularity on color Doppler sonography. Patients were referred for other imaging studies, including magnetic resonance imaging, computed tomography, and bone and labeled red blood cell scintigraphy, which did not add relevant information. Three patients underwent surgery; foreign bodies were found in 2, and infected granulation tissue was found in 1. Spontaneous resolutions and no growth of the lesions were seen in the other 2 patients. Conclusions. The possibility of a foreign body should be considered when scanning soft tissue masses even in the absence of a relevant clinical history. Once a foreign body is diagnosed, no further workup is indicated.

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Section: Discussionmentioning

confidence: 99%

Clinically Unsuspected Foreign Bodies

Soudack

Nachtigal

Gaitini

2003

Journal of Ultrasound in Medicine

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“…9 Shiels WE 2nd et al has also found the soft tissue foreign body to be hyperechoic with partial or complete acoustic shadows and with/ or without surrounding hypoechoic halo. 12 We found posterior acoustic shadowing in all our cases probably because of use of tissue harmonic sonography. Hypoechoic halo around the foreign body could be due to edema, abscess, granulation tissue or hematoma.…”

Section: Discussionmentioning

confidence: 50%

“…10 USG has been used not only for detection and localization but also to guide removal of the foreign bodies. 11,12 Our result showed that tissue harmonic sonography was 100% sensitive for the detection of the wooden foreign bodies.…”

Section: Discussionmentioning

confidence: 69%

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Wooden foreign bodies in soft tissue: role of tissue harmonic sonography

et al. 2014

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Background: Wooden foreign bodies (WFB) are usually not detectable on radiography. Ultrasound is a useful tool for detection and localization of WFB. Objectives: We evaluated the efficacy of tissue harmonic sonography in detection of WFB and describe the imaging features of WFB on tissue harmonic imaging. Methods: We retrospectively evaluated 28 patients with history of wooden (wood/thorn/bamboo) foreign body prick with tissue harmonic sonography. Results: The WFB was detected on ultrasonography in all 28 patients (100%) which was confirmed on surgery or follow up study. All WFB were echogenic casting strong posterior acoustic shadowing with or without surrounding hypoechoic halo. Conclusion: Tissue harmonic imaging is useful tool for detection and localization of retained WFB.

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“…Sonography is able to detect nonradiopaque objects such as wood and plastic, as well as radiopaque objects, and may be used to guide percutaneous removal. [19][20][21][22] Limitations of the present study include its small sample size (N ϭ 11); a homogeneous sample, obtained from a single source (a large quaternary children's hospital radiology department from 2005-2008) and characterized by patients in out-of-home placements; and use of retrospective data restricted to contents of a clinical chart. In particular, although all of the study patients had diagnoses of bipolar disorder, the clinical chart did not include data pertaining to whether SEB occurred during a manic episode.…”

Section: Figurementioning

confidence: 99%

Self-Embedding Behavior: A New Primary Care Challenge

Bennett¹,

Shiels

Young³

et al. 2011

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Self-embedding behavior is an extreme form of self-injury involving the insertion of inanimate objects into the soft tissues, either under the skin or into muscle. To date, no case series data on this behavior among adolescents has been described in the pediatric medical literature. WHAT THIS STUDY ADDS:Goals of this study are to begin to develop a clinical picture of adolescents who engage in selfembedding behavior, resulting in an understanding that allows practitioners to pursue rapid and targeted intervention to interrupt the cycle of self-harm and institute appropriate longterm therapy.abstract OBJECTIVE: The goal of this study was to define self-embedding behavior (SEB), develop a clinical profile of adolescents who engage in SEB, and emphasize the importance of rapid, targeted, and effective identification and intervention. METHODS:As part of a retrospective study with a database evaluating 600 patients percutaneously treated for soft-tissue foreign body removal, adolescents were identified with self-embedded soft-tissue foreign bodies. We describe patients' gender, age, and psychiatric diagnoses; SEB age of onset, frequency, and self-reported reasons; and the number, type, location of, and removal technique for objects. RESULTS:Eleven patients (9 females) who engaged in SEB were identified. Ten of the 11 patients were members of a group home or psychiatric facility at the time they engaged in SEB. All patients had previous and multiple psychiatric diagnoses. SEB mean age-of-onset was 16 years, and mean number of SEB episodes per patient was 1.9. The most common self-reported purpose for SEB was suicidal ideation (6 of 8 [75%]) versus nonsuicidal ideation (2 of 8 [25%]), with 3 cases lacking this documentation. The mean number of objects embedded in a single episode was 2.4, usually composed of metal and embedded in the arm. Seventy-six foreign bodies were percutaneously removed (using ultrasound or fluoroscopic guidance), including metal, glass, wood, plastic, graphite, and crayon. CONCLUSIONS:SEB is an extreme form of self-injury requiring aggressive and timely interdisciplinary assessment and treatment. An understanding of SEB allows medical professionals to pursue rapid, targeted, and effective intervention to interrupt the cycle of self-harm and institute appropriate long-term therapy. Pediatrics 2011;127:e1386-e1391

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Localization and guided removal of soft-tissue foreign bodies with sonography.

Cited by 174 publications

References 2 publications

Clinically Unsuspected Foreign Bodies

Clinically Unsuspected Foreign Bodies

Wooden foreign bodies in soft tissue: role of tissue harmonic sonography

Self-Embedding Behavior: A New Primary Care Challenge

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