HSS Ultrasound of the Month Case #92

Clinical History 63 year old male with painful mass of the index finger.

Ultrasound evaluation was requested for further evaluation of the mass.

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Diagnosis: Retained Metallic Foreign Body

The foreign body was subsequently removed surgically (g= intraoperative xray after removal).

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Discussion Ultrasound is an ideal modality to evaluate soft tissue masses of the extremities.

A retained foreign body can be a source of a palpable mass, and ultrasound can easily identify foreign bodies and differentiate them from other masses.

Most foreign bodies are bright on ultrasound regardless of the type of foreign body. A very bright and linear foreign body may be either metal or glass.

An xray may be required to confirm the type of retained foreign body.

Ultrasound is also good for assessing any accompanying complications associated with the retained foreign body.

Granulomatous reaction, abscess, tendon tear, and septic arthritis or tenosynovitis are potential complications of a retained foreign body.

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