Ultrasonography of subcutaneous foreign bodies: differences depending on their nature, complications, and potential diagnostic errors

• Published in: Radiologia Vol. 62; no. 1; pp. 3 - 12
• Main Authors: Marín-Díez, E, Landeras Álvaro, R M, Lamagrande Obregón, A, Pelaz Esteban, M, Gallardo Agromayor, E
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01-01-2020
• Subjects: Calcinosis - diagnostic imaging; Cicatrix - diagnostic imaging; Diagnostic Errors; Foreign Bodies - complications; Foreign Bodies - diagnostic imaging; Glass; Hematoma - diagnostic imaging; Humans; Metals; Plants; Sesamoid Bones - diagnostic imaging; Subcutaneous Tissue - diagnostic imaging; Tomography, X-Ray Computed; Ultrasonography; Wounds, Penetrating - complications; Tejido celular subcutáneo; Doppler color; Doppler ultrasound imaging; Color Doppler; Cuerpos extraños; Ecografía Doppler; Subcutaneous tissue; Foreign bodies
• ISSN: 1578-178X; 2173-5107
• DOI: 10.1016/j.rx.2019.05.009

Patients with penetrating wounds with suspected foreign bodies retained in the wound are often seen in emergency departments. Imaging studies are necessary to rule out the presence of retained foreign bodies. Plain-film X-rays, however, are only useful when the foreign bodies contain radiopaque material (metal, glass, stone, and some plastics). In cases with strong diagnostic suspicion and negative plain films, other imaging tests are necessary. Ultrasonography has proven useful in the identification and location of both radiopaque and radiotransparent foreign bodies. Ultrasonography enables excellent assessment of adjacent anatomical structures (muscles, tendons, ligaments, and neurovascular structures) and of associated lesions. The different materials found in foreign bodies have characteristic ultrasonographic patterns that are useful for diagnosis. Finally, it is important to be familiar with the diagnostic pitfalls to avoid false positives.