Presentation
History of penetrating injury to the forearm by a metal particle for 1 day.
Patient Data
There is a tiny echogenic focus in the muscle plane near the site of skin entry. Doppler shows a twinkling artifact. There is no local collection. The adjacent radial artery is patent.
Case Discussion
The initial radiograph (not shown) demonstrated a single metal focus in the soft tissue of the forearm on the volar side.
Using grayscale ultrasound, the foreign body could not be localized initially. Switching on Doppler with high PRF, actually helped to localize the foreign body.
Surgical exploration revealed a metal-dense foreign body in the muscle plane.
As with calculus, a metal foreign body with an irregular/rough surface produces a twinkling artifact.