Presentation
Pain on planter aspect of foot - 4th toe. No recent trauma.
Patient Data
A metal foreign body is noted in 4th proximal phalanx.
USG shows tenosynovitis without tendon tear. The defect is noted in planter cortex of base of 4th proximal phalanx. Deep to defect there is reverberation artifact by metal - similar to anchor artifact in postoperative shoulder. A Doppler artifact is present at that point.
Case Discussion
Radiograph shows a metal dense foreign body in 4th proximal phalanx. History of penetrating injury was asked again. Now she remembered penetrating injury to foot by a metal pin like substance; about 18 years ago.
USG was requested for two questions :
- To check whether the foreign body is partly outside bone or not.
- Approach for incision - planter / dorsal when exploration is done.
USG: shows tenosynovitis without tendon tear. Defect is noted in planter cortex of base of 4th proximal phalanx. Deep to defect there is reverberation artifact by metal - similar to anchor artifact in postoperative shoulder. A Doppler artifact is present at that point.
Surgically removed.
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