Charm needles or "susuk" are talismans alleged to be made of gold or other precious metals, which are inserted into the soft tissue of the body. They are believed to enhance beauty, youth, health and fortune.
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Epidemiology
This practice is found among both men and women of Southeast Asian countries, commonly Malaysia, Brunei, Singapore, Thailand, and Indonesia. They are usually inserted into the soft tissues by a bomoh (Malay shaman) and can only be removed by the same bomoh.
Clinical presentation
They are often asymptomatic, incidental findings without noticeable scars on the skin. Some cultures consider this practice "forbidden", hence, the individual keeps them secret or may not even be aware of its existence (if inserted at a young age), but are revealed when radiographs are taken.
Radiographic features
Susuk needles are deemed to be MRI safe due to a lack of ferromagnetic elements in their composition 5.
Plain radiograph
These needles are radiopaque on radiographs and are between 0.5 to 1 mm in diameter and 5 to 10 mm in length. They are often inserted into the maxillofacial region and breast but may also be found in the chest, abdomen, spine, mons pubis and limbs.
Differential diagnosis
- surgical clips
- acupuncture needles
- brachytherapy seeds