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Age / Sex : 8 / M
8/M
C.C.: sudden left knee pain, focal soft tissue swelling, medial & lateral portion of the knee (Click to enlarge)
1) What is your impression?
Courtesy : Ik Yang, MD
Kangnam Sacred Heart Hospital Hallym University Medical Center
Diagnosis: penetration injury by a wooden foreign body
Discussion
Findings:
1) Simple X-ray: - No bony lesion. - Normal joint space. - Left knee: focal soft tissue density at medal and lateral portion of the knee
2) MRI: - Focal soft tissue swelling, medial and lateral portion of the knee
3) US; Linear echogenic lesion
- C/W wooden foreign body
Differential Diagnosis: None
Diagnosis: penetration injury by a wooden foreign body
Discussion:
1. Fall down injury during sleeping at bed ==> Wooden foreign body penetration injury ==> US is useful for the detection of non-radiopaque foreign body
2. Plain radiographs only detect foreign bodies usually consisting of metal or glass. Foreign bodies invisible on Plain radiographs can often be easily identified, usually appearing hyperechoic, on sonography. Ultrasound is useful in the detection and localization of radiolucent foreign bodies such as wood or thorns. Additionally, the involvement of adjacent soft tissue structures,the inflammatory reaction,and possible abscess formation can all be depicted on sonography.
References:
1. Jacobson JA, Powell A, Craig JG, Bouffard JA, van Holsbeeck MT. Wooden foreign bodies in soft tissue: detection at US. Radiology 1998; 206: 45-48
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