Presentation
A few days prior to presentation, this patient had a left thumb penetrating injury due to a sickle (agricultural tool). She presented with complaints of thumb pain, swelling and restricted movements.
Patient Data
There is a metal density focus overlying the interphalangeal joint of the thumb. There is no bone erosion/ fracture/dislocation.
There is a well-defined linear echogenic focus on the palmar-radial side of thumb at the interphalangeal joint. It is a foreign body; measuring about 4 mm. There is moderate synovitis involving the joint. There is no bone erosion. Flexure and extensor tendons are intact. There is no flexure tenosynovitis.
Intra-operative photos show a foreign body in the interphalangeal joint. It was a metal fragment which was removed.
Case Discussion
A female had a left thumb penetrating injury due to a sickle. She presented with a healed wound but with pain, swelling and restricted movement involving the thumb. Radiographs showed a metal dense focus overlying the interphalangeal joint of the thumb. Ultrasound favored an intra-articular location of the foreign body which was confirmed at surgery. The metal foreign body was removed. It was one of the teeth of the sickle.
Photos courtesy of operating surgeon Dr Niraj I. Patel.
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